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Regional Medical Economics Director - Healthcare Marketplaces and Individual Exchanges

Company: UnitedHealth Group
Location: Minnetonka
Posted on: September 12, 2020

Job Description:

Improve the lives of others while doing your life's best work. SM Regional Medical Economics Director - Healthcare Marketplaces and Individual Exchanges - Telecommute (880711) Are you ready to deliver bold, business-savvy solutions to help millions live healthier lives? UnitedHealth Group is where some of the most innovative ideas in health care are created every day. As the Regional Medical Economics Director, you will lead the team performing critical research and investigating key business issues in order to find viable, real-world solutions in a complex health care landscape. You will manage a team that interprets and analyzes clinical data to proactively identify, communicate and lead organizational dialogue related to health care opportunities and risks. You'll interact with senior leadership with a focus on performance to achieve business objectives. This is where your bold ideas will write the next chapter in health care. This is the place to do your life's best work.(sm)

Positions in this function research and investigate key business problems through quantitative analyses of utilization and healthcare costs data. Provides management with statistical findings and conclusions. Identifies potential areas for medical cost improvements and alternative pricing strategies in collaboration with the Regional leadership team, key functional (clinical, network, actuarial and payment integrity) leaders and market Health Plan leaders.

If you are located in Phoenix, AZ or Minnetonka, MN, you will have the flexibility to telecommute* as you take on some tough challenges. Full-time telecommuting from other locations will be considered as well.

Primary Responsibilities:

Lead and direct a C&S Medical Economics team of managers and analysts including shared service business partners. The team will be dedicated to supporting Healthcare Exchange plans across the nation

Lead trend analytics to identify root cause issues to support the monthly clinical close process and potential remediation opportunities within Network, Payment Integrity, Clinical, and Quality

Develop new and innovative ways to leverage data to drive business operations in a new and growing segment

Work with segment finance teams and affordability leads to standardize reporting, scorecards, metric definitions and drive affordability improvements in the local markets

Develop tiering models (clinical performance and quality) integrating key data points from other matrix partners to evaluate network and clinical performance on a continual basis

Evaluate new market expansion opportunities and provide analytic support and direction to the new market teams; new market checkbook and clinical managed care assumptions

Support provider settlement process by analyzing exposure and developing estimates in conjunction with cross functional team including UHN, Legal, and Operations

You’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:

Bachelor’s degree (Finance, Statistics, Accounting, Economics, Computer Science, Healthcare Informatics, Actuarial Science, Business or other degrees + 5 years of finance/analytic experience)

5+ years of healthcare analytics / finance / economic experience

3+ years working within the Healthcare Exchange industry

Previous experience with Medical Economics with Individual Exchanges

Experience interfacing with senior executives on a regular basis

Proficient working with MS Excel including advanced formulas, pivot tables, macros, lists, statistical functions, etc.

Preferred Qualifications:

Master’s degree (e.g. MBA, MPH, MHA, etc.)

2+ years of experience leading large multi-level analytic teams

Experience executing and delivering on strategic analytical initiatives within a large-matrixed environment

Intermediate proficiency working with query, business intelligence and statistical tools, including MS - SQL, SAS, Tableau, SSRS and / or R

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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) *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. Job Keywords: Regional Medical Economics Director, Medical Economics Director, Healthcare Economics, Medical Economics, Healthcare Marketplaces, Individual Exchanges, Statistical Analysis, SAS, SQL, R, SSRS, Pivot Tables, Macros, Healthcare Informatics, Telecommute, Telecommuting, Telecommuter, Work From Home, Remote, Minnetonka, MN, Phoenix, AZ, Minnesota, Arizona, United States

Requisition Number 880711

Job Title Regional Medical Economics Director - Healthcare Marketplaces and Individual Exchanges - Telecommute

Job Family Healthcare Economics

Business Segment UnitedHealthcare Finance

Job Location Information UnitedHealth Group is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or accommodation for any part of the application process, please call 1-800-561-0861 and press or say 1 for Applicant to be connected to Recruitment Services. Recruitment Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through Friday.

UnitedHealth Group is a registered service mark of UnitedHealth Group, Inc. The UnitedHealth Group name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the UnitedHealth Group, Inc.

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 , Regional Medical Economics Director - Healthcare Marketplaces and Individual Exchanges, Other , Minnetonka, Minnesota

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