Associate Director, Market Operations - McAllen, TX
- McAllen, TX
Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)
The Associate Director of Market Operations has management responsibility for day to day market operations. The position is responsible for facilitating the creation and execution of local market strategies and action plans. The position is involved in planning, budgeting, forecasting, facility planning and reporting for each of the assigned markets. This will include overseeing network development, network management and local office management in assigned markets. This position may supervise multiple markets as directed. This position has a dotted line matrix management responsibility for all other functional staff located within assigned markets - including marketing, utilization management, disease management, transportation, DataRAPS, quality and vendors. This position works cross functionally with all other divisions in the corporation including, medical management, , finance, claims, customer and member services, IT and facilities to achieve market goals and objectives. The responsibilities of this position demand a wide range of capabilities including: strategic planning and analysis skills; strong accounting knowledge and understanding of financial statements; understanding of managed care contracts; management breadth to direct and motivate; highly developed communication skills; political savvy; and the ability to develop clear action plans and drive process, given often ambiguous issues with numerous interdependencies. Analyzes data from a variety of statistical and financial reports and develops recommendations, strategic plans and action plans to improve identified financial deficits. This position will work closely with key payor and physician groups to develop long-term strategic relationships.
- Responsible for supervision of market personnel to include hiring, training, coaching and development to maximize staff performance and technical expertise through clearly defined objectives and leadership
- Participates in strategic and operational planning for the assigned market(s) and facilitates the execution of the plan within that assigned market
- Identifies, directs, communicates and executes continuous quality improvement activities or processes to ensure initiative outcomes are met
- Participates in development and implementation of systems that support network operations and network management
- Delegate, monitor and control work progress on keymetrics, initiatives/action plans, staff productivity and administrative expenses
- Overall responsibility for the selection of additions to the primary care network. This includes creation of strategic plan, training of the staff to carry out the strategic plan, negotiation of the contract as well as overall implementation of new primary care provider groups
- Maintains effective network support services by working effectively with the Medical Director, Market Medical Director and other departments
- Handles complex and/or difficult provider inquires and/or problems and facilitates resolution of provider issues. Continuously strive to ensure that favorable relationships are maintained while ensuring the interest of the organization
- Drives change and innovation through continually seeking and implementing value added solutions for clients
- Communicate and advocate providers' needs to internal stakeholders in order to drive creation of solutions that meet our mutual business goals
- Leads multiple individual client-focused projects and motivates cross-functional participants to improve or address systematic problems or providing value to client
- Influence or provide input to forecasting and planning activities
- Analyzes data while collaborating and/or participating in discussions with colleagues and business partners to identify potential root cause of issues.
- Provide cross functional leadership across the enterprise by maintaining open communication, identifying, resolving cross functional issues, attain metric targets by collaboratively creating, maintaining, implementing and evaluating business strategic plans for each area, continually improving cross functional policies/procedures/work flows and support systems and proactively facilitates staff development to achieve the goals and objectives of the market
- Assists with and manages business projections, forecasting and budgets, both financially and with timelines, for assigned projects.
- Understands payer relationships within market and ensures any operational issues are visible to the appropriate parties and ensures issue resolution.
- Performs all other related duties as assigned
It's time to step up to some real challenge. You'll be part of a performance driven, fast paced organization that is serving multiple markets and you'll be managing and mentoring a production based team to meet aggressive goals.
- Bachelor's degree in Business Administration, Marketing, Healthcare Administration or a related field required. (8 additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor's degree)
- Minimum of 5 years of managed care experience with an emphasis on network management, operations, financial analysis and employee supervision. Provider contract negotiations and provider relations experience
- At least 4 years of management/supervisory experience (i.e. employee selection, training, coaching and development as well as process management)
- At least an intermediate level of knowledge of claims processing
- 1+ years of experience with Medicare and Medicaid regulations
- Exceptional presentation, written and verbal communication skills
- Ability and willingness to travel, both locally and non-locally, as determined by business need
- Proficiency in MS Word, PowerPoint, Excel and Access
- Master's degree in Business Administration, Marketing, Healthcare Administration or a related field
- Strong working knowledge of Medicare health care operations including HEDIS, HCC Coding and Medicare Advantage
The health system is moving ahead. You can too as you help us build new levels of provider network performance. Join us. Learn more about how you can start doing your life's best work.(sm)
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: Provider relations, supervisor, manager, Network Operations, McAllen, TX, Texas,
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