VP, Risk Adjustment Solutions & Ops Support - Santa Ana, CA
- United States
If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm)
Clinical Performance (CP) is charged with effectively implementing, monitoring, and executing on clinical documentation, quality, and affordability programs that promote patient health while improving the provider practice experience with a special focus on Medicare Risk Adjustment and HEDIS. Clinical Performance processes on a national level by providing support in all markets served by OptumCare Delivery.
The Vice President of Risk Adjustment Solutions and Operations Support will be responsible for building, scaling, and supporting solutions and capabilities that generate value and a unified experience to market based customers. This individual will play the role of Risk Adjustment expert and trusted advisor to both internal and external stakeholder, and will require direct collaboration and influence with senior-level leaders across Optum Care to drive Risk Adjustment program strategy, innovation and execution.
- Builds new Risk Adjustment solutions and/or modifies existing solutions that deliver sustainable, financially sound solutions that solve a specific problem and enable successful
- Define future capability direction that supports business strategy and new opportunities
- Leverage market insights to monitor trends and external landscape, and to inform capability strategies and customer use case scenarios
- Consult with and support CP Market Relations team with all Risk Adjustment programs and initiatives
- Communicate effectively with all level of staff and leadership ensuring messages appropriately tailored to audience whether delivered verbally or in written format
- Leads key strategic initiatives and provides leadership for large complex programs.
- Support corporate development
- Build relationships and leverages a network of experts - internal and external - that enhance Risk Adjustment innovation and performance
- Identifies and leverages solutions/tools/processes deployed in individual markets that can be utilized at scale across the enterprise
- Informs/influences key stakeholders on significant business or client risks even when others are responsible for course of outcome
- Collaborates with CP operational leaders to build value roadmaps
- Conducts research and data analysis with the intent of guiding Risk Adjustment strategies and plans across all lines of business
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.
- Bachelor's degree or equivalent experience required; Master's degree preferred
- 5+ years of Risk Adjustment experience - expert status expected
- 3+ years of progressive leadership experience including leading operations, and/or business process improvement initiatives
- Technical competency with experience creating and applying data analytics to solve business problems
- Strong leadership skills with proven ability to foster and manage senior-level relationships in a highly matrixed environment
- Superior verbal and written communication skills
- Ability to influence with and without direct management/authority
- Superior customer/consultant relationship management and collaboration skills
Careers at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.(sm)
Diversity creates a healthier atmosphere: 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
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