Remote Prior Authorization Team Lead Jobs in Springfield, MA

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

As new pharmacy clients are welcomed to OptumRx, the new client implementation team offers a best-in-class onboarding experience that is powered by solid governance and project management.  Our Health Plan Implementation team is a separate and distinct division that handles our most sophisticated new Health Plan clients.  The Governance Lead for New Client Implementations will be an individual contributor with responsibility for overall governance of the implementation and oversight of the Senior Implementation Project Managers assigned to the client, and reports to the Sr. Director, Health Plan New Client Implementation.  As a key member of the health plan implementation leadership team, you will have key responsibilities to work closely with other Directors to drive new processes and create custom solutions to drive efficiency.

For the new clients that are assigned to your team, you will own the overall strategy for maintaining client satisfaction, establishing client expectations (in accordance with client contracts, agreed upon enhancements), and communicating these expectations with functional leaders.  In addition, you will be responsible for developing custom client delivery plans, ensuring consistent execution that exceeds our clients' expectations, and managing the client relationship.

You will have significant responsibility and active engagement with all operations and account management leaders across the OptumRx organization to deliver on our promises and handle escalations throughout the implementation process. In this role, you may also have the opportunity to participate in the sales process for new clients, this includes reviewing and preparing RFP responses, attending prep sessions and participating in finalist sales presentations, consultation relations, and capability demonstrations.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

• Serves as a key leader on the Health Plan Implementation team.  In addition, leads training efforts for new and existing team members, and serves as role model
• Partners with Client Executives and key business stakeholders throughout the implementation process to develop and execute strategic client plan that addresses client's business needs (current and emerging), supports growth, provides value, and increases client engagement and loyalty
• Establishes, cultivates, and manages the customer relationship at multiple levels, (executive suite to solution owners) serving as a trusted business advisor / partner to the client and to key internal stakeholders within OptumRx
• Supportsclient growth by serving as a resource for Account Management for growth initiatives with existing clients
• Serves as escalation point to assist with the engagement of cross functional client teams on the delivery of services, escalating issues where necessary and driving resolution
• Partners with functional teams accountable to deliver against client requirements and expectations
• Serves as key lead in managing client implementation performance guarantees to ensure all project measures are successfully met
• Ensures Client Satisfaction and client willingness to serve as a reference
• Exceptional written, verbal, and active listening skills, with the ability to communicate complex information clearly and effectively to diverse audiences, driving engagement and influencing outcomes
• Demonstrated ability to build relationships, influence stakeholders at all levels, and foster cross-functional collaboration to achieve shared goals and mutually beneficial solutions
• Proven consultative approach to understanding client needs, identifying business challenges, and developing strategic solutions that support organizational objectives and client success
• Ability to effectively navigate complex, matrixed organizations and drive results through collaboration across operational, network, and clinical functions

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)
• 6 years of experience working with health plans
• 6 years of Implementation or large healthcare project management experience
• 6 years of executive experience working with senior and C-Suite executives 
• 6 years of plan management experience with Medicaid and Medicare and Health Care Exchange
• Experience working with complex health care solutions (e.g., outsourced health care solutions) 
• Ability to travel up to 50%

Preferred Qualifications:

• Master's Degree
• Project Management Professional Certification
• Pharmacy Benefit Consulting experience in the Health Plan market segment

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $112,700 - $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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