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Program Manager of Medicare Advantage Expansion & Network Strategy - Telecommute

Company: UnitedHealth Group Inc.
Location: Minnetonka
Posted on: May 3, 2021

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)

The Product Manager of M&R Expansions & Network Strategy will support Director managing all product expansions for UnitedHealthcare Medicare & Retirement (M&R) and Community & State (C&S) for the Medicare markets. The expansion process has been a strategic focus area for M&R and C&S annually with planned expansions to a significant number of new states / counties. The role will also be responsible for assisting in managing all Provider components for network expansions and additional product strategies (i.e. provider specific plans, referral required program, etc.).

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

As a M&R product manager for expansions and other product programs, this position plays an essential role in leading the process for growth for new markets and geographic expansions. Some specific job components include, but are not limited to:

  • Annual M&R Medicare Advantage Expansions
  • Execute on strategy for annual Medicare Advantage expansions for new counties in existing state markets and entry into new states/markets with M&R and C&S Product and Market leadership
  • Partner with Health Plan CEOs to establish MA service area/product expansions
  • Partner with Underwriting, Finance, Treasury, UnitedHealth Networks (UHN) and Legal on all work products associated with expansion; ensures timely completion in advance of internal and CMS deadlines
  • Participate in strategy discussions with Legal, Compliance and Treasury on available licensure for intended expansion markets / states
  • Submit annual CMS applications, in accordance with all CMS requirements and Health Plan filing strategies
  • Maintain working relationship and communication with CMS Regional and Central office contacts for the entire expansion process
  • Ensure all operational teams have provided necessary and accurate detail for applications as well as attestations
  • Ensure network readiness for expansion and active counties including oversight of network adequacy
  • Engage other areas such as market intelligence, network, operations/performance excellence, sales / marketing to begin the readiness activity for expansion markets
  • Collaborate on contract mapping / consolidation and license recommendation for new markets and expansions
  • Ensures CMS bid submission contains complete and accurate list of expansion counties as directed by the Health Plan CEO

Resolve conflicts and issues related to annual Medicare bid process for expansions; escalate issues as needed

  • Work with capital funding work stream to assess if there are opportunities for development of enhanced tools utilized in network and product functions for expansions
  • Develop and manage contingency plans to ensure application process will go forward in the event key staff are unavailable

  • Ongoing Network Adequacy Oversight
  • Partner with UHN, Regulatory Affairs, and health plan leadership to ensure networks are continuously monitored for gaps, and expansion strategy is adjusted as necessary to account for network inconsistencies in existing service area
  • Collaborate on CMS advocacy positions related to ongoing network oversight and monitoring

  • Provide guidance around system configuration for new and existing plans / benefits
  • Assist with development of data reporting and analysis capabilities within MA Product team

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 or equivalent experience
  • 2+ years of business experience within health care government programs (Medicare, Medicaid, etc.)
  • Experience managing a variety of complex initiatives while driving momentum on key projects by accurately scoping out projects, setting / measuring progress against goals and developing / managing schedules / resource assignment
  • Project management experience of large cross-functional programs
  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained

Preferred Qualifications:

  • Experience working within the CMS Health Plan Management System (HPMS)
  • Solid communication (written and verbal) and analytical skills
  • Strategic thinker with a keen sense of the business and our Federal & State partner needs
  • Solid ability to collaborate and integrate multiple perspectives, yet willing and able to be decisive to achieve a strategic vision
  • Demonstrated ability to establish collaborative working relationships with executive staff

Careers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in health care. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.(sm)

  • All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Colorado Residents Only: The salary range for Colorado residents is $79,700 to $142,600. 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

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: Product Manager of M&R Expansions & Network Strategy, Telecommute, Remote, Work from home

Keywords: UnitedHealth Group Inc., Minnetonka , Program Manager of Medicare Advantage Expansion & Network Strategy - Telecommute, Other , Minnetonka, Minnesota

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