Remote Ria Operation Manager Jobs in Massachusetts

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.

The Sr. Account Manager drives retention and growth through development of account strategies and business relationships with external clients.  In this role, the focus will be on delivering best-in-class service to clients, leading and managing internal and external relationships, as well as developing new business from existing clients. The ability to proactively identify client's needs and establish proactive plans will be key in this role. This role will conduct customer consultations, lead applicable negotiations and work with internal partners to support client commitments & contractual deliverables.
 

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Operational Management:
  • Own complex client readiness and enablement activities, including leadership of the end to end Readiness process, operational maintenance activities, benefit updates, file updates, and coordination across multiple operational and client-facing teams
  • Ability to define, create, execute and train on process improvements and industry best practices
  • Lead annual readiness, go-live support, operational transitions, and daily readiness updates/progress reporting with clients and internal functional partners
  • Support & facilitate training of all OptumRx client-facing systems & tools
  • Initiate and manage end-to-end enterprise operational readiness project plans, including task duration, sequencing, team resourcing, dependencies, issue resolution, and full execution across cross-functional teams
  • Own the day-to-day service experience of customers by working with the Operations Team and other functional partners as required to ensure issues are resolved promptly and accurately meeting the customer's expectations
  • Serve as a critical bridge between Account Management, Operations, Implementation, Product, and Client stakeholders to drive operational readiness, issue resolution, and strategic initiatives
  • Coordinate activities to support impact reporting, root cause analysis, and full remediation
  • Ability to develop, negotiate, analyze, interpret, and implement SOPs and reporting
  • Lead cross-functional projects, process improvement initiatives, and organizational readiness efforts that support client outcomes, enterprise priorities, and continuous evolution of the Health Plan Enablement model
  • Recognizes cost avoidance opportunities and offers solutions
  • Serves as a mentor to Account Manager and CSM roles
  • Seeks stretch opportunities to expand knowledge and skillsets
• Client Relationship Management:
  • Establish and maintain solid and appropriate relationships with customers to maintain consistency and drive client satisfaction
  • Maintain client action logs and facilitate regular cadence of discussions to review
  • Conduct meetings with customers to identify issues / trends and analyze root causes to determine corrective action steps as necessary
  • Demonstrate a high level of knowledge pertaining to the customer's specific benefit design and needs
  • Ability to develop, negotiate, interpret/translate, communicate, and execute client and enterprise requirements
  • Ability to recognize, anticipate and manage downstream and upstream impacts to ensure project success/client satisfaction
  • Function as both a strategic consultant and operational leader, balancing client relationship management, project execution, organizational influence, and consultative guidance focused on best practices and optimal outcomes

Competencies:

• Behavioral
  • Critical thinking
  • Problem solving
  • Conflict resolution (internal & external)
  • Solid written and verbal communication skills
  • Project Management
  • Strategic consultation
• Technical
  • Chief of Staff responsibilities - The ideal candidate is a highly strategic and operational leader with exceptional executive communication, cross-functional influence, program management, business analytics, and organizational effectiveness capabilities. This individual must be able to translate executive vision into actionable plans, drive enterprise initiatives, influence senior stakeholders, manage competing priorities, and ensure successful execution of critical business objectives while serving as a trusted advisor to leadership.
  • Proficient in Microsoft applications and Smartsheets
  • Has experience with using PBM tools to drive operational activities (reporting tools, issue management tools, claims adjudication, etc.); able to teach tools to others

This is more than a traditional Account Manager role. The successful candidate will seamlessly navigate client management, operational enablement, project leadership, and strategic consulting while helping continue to evolve and strengthen the Health Plan Enablement model. This is a unique opportunity to apply PBM, health plan, or managed care expertise in a new way that benefits clients, internal partners, and the larger enterprise.
 

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:

• 5 years of external client-facing healthcare account management and relationship leadership experience
• 3 years of project management experience with the ability to lead complex, cross-functional initiatives to meet project deadlines; PBM, health plan, or managed care experience preferred
• 3 years of experience in tracking, planning projects, working with large data sets and making data-driven analytical decisions
• Experience with Microsoft Project or Smartsheet
• Experience with annual PBM client readiness, go-live support, operational transitions, or large-scale change initiatives
• Solid PBM, health plan, or managed care experience; experience across all lines of business highly preferred, including Med D/Medicaid and CMS requirements as they relate to the pharmacy benefit
• Material creation and presentation facilitation for executive audience
• Proven ability to influence, problem-solve, and drive outcomes across teams without direct authority, including coordination with internal partners on mitigation strategies and issue management resolution
   

Preferred Qualifications:

• 3 years PBM specific project management experience 
• Governance PMO experience
• Experience with ServiceNow Dashboards
• KPI creation, measuring and reporting
• Experience and understanding of PBM Client impact reporting, root cause analysis and full remediation 
• Med D/Medicaid; understands CMS compliance requirements & relationship to STAR ratings, delivers guidance memos to client; leads activities related to Corrective Action Plans (CAPs); provide consultative support to our clients
  

*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 $91,700 - $163,700 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.