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Value Based Reimbursement Implementation Manager, Medicare & Retirement - Telecommute

Company: UnitedHealth Group
Location: Minnetonka
Posted on: June 22, 2022

Job Description:

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing -your life's best work.(sm)Join us to conduct, manage and drive projects and resources that result in successful implementation of a variety of Government Operations global risk capitation, PCP capitation or other value based arrangements, including claims and clinical delegation between UHC and OptumCare or other external entities. - Develop your business knowledge of Medicare and Medicaid products, contracting practices, and Federal or State regulations while coordinating activities across more than 20 departments involved in a common purpose to serve our Medicare as well as Community and State beneficiaries.The selected candidate will become a subject matter expert in the area of operational tasks, sequencing and delivery of capitation, delegation and other risk based contracting. -He or she will be viewed as a trusted partner for Government Operations teams, delivering with clarity, speed, quality and transparency. -You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. -Primary Responsibilities:

  • Lead activities for assigned Delegation or Capitation initiatives for COSMOS, NICE or CSP Facets
  • Ensure alignment and understanding of program/project scope and objectives with the organization's strategic objectives, in consultation with applicable stakeholders
  • Guide teams across multiple disciplines as they complete implementation tasks including provider setup, benefits, ID cards, claims, portals, member services, provider services, enrollment, encounters, mis-directed claims process or other. -Coordinate with SMEs to address task sequencing and to help obtain information necessary to each team. -
  • Develop project plans that define key tasks and milestones, taking feedback from SMEs and stakeholders. -Content includes suggested target dates and responsible team(s)/SME(s). - Modify plans and customize as needed over time. -
  • Facilitate and manage mid to large size workgroups, enabling a culture of collaboration, trust and disciplined accomplishment of tasks and target dates. -
  • Probe at and document issues and set up calls outside the formal workgroup where needed to resolve open items; escalate critical issues quickly when needed -
  • Assume ownership, over time, of one or more core team tools, applying project lifeycle experiences to improve our delivery and management of projects
  • Completes weekly status, monthly stakeholder and other applicable reports or dashboards - -
  • Establish, develop and maintain effective relationships with applicable project stakeholders including but not limited to project team members, delegated entity teams, internal customers, functional SMEs, business partners, leadership.
  • Demonstrates ongoing ability to grow one's knowledge of end to end global risk, capitation and delegation -from a process and systems function level, including knowledge -of -the business segment and related business teams involved in the -scope of work
  • May be required to document and groom capabilities for IT projects, with ability to elicit, understand -and articulate customer needs. -This may include oversight of the accuracy of features and/or user stories in Agile Rally -
  • Acts as a resource for others; readily shares knowledge
  • Complete recommended and optional online coursework and orientation sessions to learn and deepen knowledge on capitation, delegation, risk based contracting, Government Operations and our platforms -
  • Ensures operations is protected e.g. drives solutions that do not require significant adds to staffing, influences direction away from approaches and strategies that Operations cannot administer
  • Drive process improvement activity where assigned, including definition of problem statements, metrics or data gathering if appropriate, facilitate work group dialogue, identify participants, support ideation and solutions or tools needed.
  • Assume ownership, over time, of one or more core team tools, applying project lifecycle experiences to improve our delivery and management of projects
  • Coordinate transition of clinical care from UHC to a capitated/delegated entitySkills and Competencies for Success:
    • Self directed, able to find answers/clarifications if not known -
    • Ability to effectively interact with multiple teams in a fast paced environment -
    • Ability to prioritize in an environment of rapid change
    • Takes accountability for decisions
    • Willingness to handle a variety of different types of project assignments when necessary vs. a fixed role/function
    • Excellent communication, time/project management, problem solving, organizational, and analytical skills required -
    • Ability to build relationships
    • Ability to break through barriers that impede progress
    • Strong business partner focus -
    • Self-starter; team player; quality minded; focused; committed; work independently
    • Ability to stay committed to long-term project goals
    • Ability to manage through diverse opinions and personalities -
    • Capable of researching details if provided the tools and if provided the overviews of how to use themYou'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications:
      • 3+ years of project management experience including prior experience in successfully managing one or more major projects which integrated multiple business areas or systems
      • 2+ years facilitating end to end mid to large size workgroups -
      • 2+ years experience developing tools, task plans, milestone charts, status reports
      • Intermediate or greater level of proficiency with Excel, PowerPoint, Word -
      • Demonstrated experience with process improvement, workflow, benchmarking and / or evaluation of business processesPreferred Qualifications:
        • Bachelor's degree in Business, Finance, Health Administration or related field
        • Advanced degree
        • 3+ years COSMOS, NICE, CSP Facets experience or other Medical Claims System experience
        • Experience with Agile methodology -
        • Experience with clinical programs/services within a managed care organizationTo protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employmentCareers with UnitedHealthcare. -Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do -your life's best work.(sm)Colorado, Connecticut or Nevada Residents Only: -The salary range for Colorado residents is $82,100 to $146,900. The salary range for Connecticut / Nevada residents is $90,500 to $161,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. -UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: UnitedHealth Group, Minnetonka , Value Based Reimbursement Implementation Manager, Medicare & Retirement - Telecommute, Executive , Minnetonka, Minnesota

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