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UnitedHealth Group

Director Contracted Operations - Laredo, TX

Laredo, TX

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.(sm)

The 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; solid 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.

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Primary Responsibilities:

  • 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 key metrics, initiatives/action plans, staff productivity and administrative expenses
  • Overall responsibility for the selection of additions to the primary care network (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

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 in Business Administration, Marketing, Healthcare Administration or a related field
  • 5+ years of experience in managed care with an emphasis on network management, operations, financial analysis and employee supervision
  • 4+ years of experience in management/supervisory (i.e., employee selection, training, coaching and development as well as process management)
  • Provider contract negotiations and provider relations experience
  • Solid working knowledge of Medicare health care operations including HEDIS, HCC Coding and Medicare Advantage
  • Knowledge of state and federal laws relating to Medicare
  • Ability and willingness to travel, both locally and non-locally, as determined by business need
  • Ability to work onsite in an office environment

Preferred Qualification:

  • Master's degree in Business Administration, Marketing, Healthcare Administration or a related field

Physical & Mental Requirements:

  • Ability to lift
  • Ability to push or pull heavy objects
  • Ability to sit for extended periods of time
  • Ability to stand for extended periods of time
  • Ability to use fine motor skills to operate office equipment and/or machinery
  • Ability to properly drive and operate a company vehicle
  • Ability to receive and comprehend instructions verbally and/or in writing
  • Ability to use logical reasoning for simple and complex problem solving

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Client-provided location(s): Laredo, TX, USA
Job ID: UHG-2139415
Employment Type: Other

Perks and Benefits

  • Health and Wellness

    • HSA
    • On-Site Gym
    • HSA With Employer Contribution
    • Health Insurance
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • Short-Term Disability
    • Long-Term Disability
    • FSA
  • Parental Benefits

    • Non-Birth Parent or Paternity Leave
    • Birth Parent or Maternity Leave
  • Work Flexibility

    • Remote Work Opportunities
  • Office Life and Perks

    • Commuter Benefits Program
  • Vacation and Time Off

    • Leave of Absence
    • Personal/Sick Days
    • Paid Holidays
    • Paid Vacation
  • Financial and Retirement

    • Relocation Assistance
    • Performance Bonus
    • Stock Purchase Program
    • 401(K) With Company Matching
    • 401(K)
  • Professional Development

    • Promote From Within
    • Shadowing Opportunities
    • Access to Online Courses
    • Tuition Reimbursement
  • Diversity and Inclusion

    • Diversity, Equity, and Inclusion Program

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