Associate Director of Clinical Operations - San Juan, PR

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The overall purpose of the Clinical Associate Director position is to lead a department of licensed and non-licensed professionals. The Associate Director of Operations will be supporting Puerto Rico and other operations through automation, productivity and quality improvements. Positions in this function include those responsible for management and administration of multiple functions, or management of general business operations. May manage the P&L of a business or part of a business unit. Manage daily operations of multiple levels of staff and multiple functions/departments across one or more business units. May include day to day site operations, management leadership internal and external to organization, accountable for financial and non-financial results (budgets and actuals). Project management and implementation, staff management.

• Sets priorities on business expectation on Performance goals, Quality, Adherence, Turnaround Time, Error correction
• Lead by example in all aspects of the business
• Lead internal management reviews, business reviews and quality reviews discussions with customers
• Participate in management appraisal cycle discussions
• Drive innovation and process improvements
• Analyze team performance and formulate action plans to address opportunities
• May be assigned to work on special projects and business initiatives
• Utilize standard project plan templates to create and/or tailor project plans to specific customers' needs
• Assist internal and/or external business partners with completion of tasks and resolution of issues and problems with program implementation
• Establish and/or implement internal and/or external service level agreements in order to ensure ability to monitor and measure program performance (e.g., turnaround time; quality; effectiveness)
• Identify and/or secure resources (e.g., funding; staffing; system security; real estate and/or telecommuting requirements; hardware/software) required to implement programs
• Review, create, and/or maintain workflows to ensure they are up-to-date and operationally efficient
• Provide guidance, expertise, and/or assistance to internal and/or external partners (e.g., claims; call center; benefits; clinical) to ensure programs and strategies are implemented and maintained effectively
• Communicate with and help internal and/or external partners interpret contractual requirements in order to ensure effective problem solution and strategy implementation
• Ensure performance is tracked accurately utilizing internal tools and processes (e.g., dashboards; scorecards; reports)
• Request and/or receive relevant performance data from internal partners and review for accuracy
• Manipulate provided data into applicable tools and reports in order to facilitate performance review and analysis
• Review consolidated operational performance reports in order to determine overall effectiveness, make necessary changes, and identify opportunities for new programs or program consolidation or expansion
• Incorporate operations program performance information into strategic and business planning especially managing new transitions
• Utilize stakeholder input to help shape and implement continuous improvement in operational quality and financial performance (e.g., encourage participation in Six Sigma projects)
• Ensure internal partners and/or external vendors adhere to business and contractual agreements
• Conduct end-to-end testing of applicable processes, tools, procedures, and systems platforms to validate adherence to RFP/contract requirements
• Utilize relevant systems and tools to identify and/or test opportunities for efficiency improvements (e.g., parallel variable testing)
• Work with relevant internal partners (e.g., Finance; Underwriting) to identify resource requirements and/or create budgets and forecasts
• Review and assign projects/initiatives based on resource capacity, capability, and expertise
• Understand different billing models within Optum
• Other duties may apply. Willing to take on any additional responsibilities

• 8+ years of experience working with leaders in matrix organizations
• 5+ years of experience in BPO or healthcare industry/Operations/Voice Operations
• 5+ years of experience utilizing operational metrics, data/analytics, goals/objectives, and dashboards to run, interpret, and drive business performance
• 5+ years of leadership experience
• Experience with the Microsoft Office Suite (Word, PowerPoint, Excel, and Outlook)
• Proficiency in using advanced functions in Microsoft Excel such as filters, pivot tables, formulas
• Professional proficiency in English
• Willingness to work flexible schedules as necessary

• Experience working in managed care/prior authorization
• Experience managing field based/telecommuting employees
• Dual diagnosis experience to include mental health and substance abuse
• Knowledge of evidence based best practice guides
• Knowledgeable of community resources