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)
Reporting to the Executive Director of Operations, the Associate Director of Healthcare Operations will have a dotted line to the local Market President and will serve as an individual contributor- while working closely with the operational department heads. The Associate Director will act as an Operations subject matter expert in working with the growth team and local leadership. The Associate Director will provide guidance regarding feasibility of implementing proposed risk contracts, educate potential and existing clients regarding capabilities, and ensure a close connection between local market needs and operational capabilities and capacity.
The Associate Director will sit in the local market office and will be responsible for maintaining a high level of satisfaction from the local leadership teams regarding Operations performance, and overall responsiveness and attention from Operations.
- Act as the primary senior contact for local issues related to our shared service operations (service, claims, eligibility, utilization management, prior authorization, payment integrity, provider data management, configuration, IT, project management, etc.)
- Work collaboratively with the heads of centralized operations regarding local market issues
- Accountable for ensuring the shared services operating metrics consistently meet and/or exceed all compliance requirements as well as key performance targets and associated service level agreements established with the local Market
- Work with staff and senior management to develop and implement improvements and oversight for all operational areas that impact performance
- Act as advocate for local market needs and influence change within Operations to meet customer needs
- Act as an advocate for Operations when influence is needed within the local market team
- Develop relationships with the local provider community
- Educate providers on billing issues, portal navigation, claims policies, and other information
- Work with Operations leadership to design innovative ways to enhance our service model and improve customer satisfaction
- Directs analytical activities to identify trends and potential opportunities within our Shared Service Operations functions that may impact the affordability of the local Market
- 7+ years of experience in managed care and operations management
- 7+ years of implementation and/or project management experience
- 7+ years client management relationship
- Experience creating and monitoring performance scorecards and/or performance metrics (KPI)
- Knowledge Lean Methodology
- Experience in Analytical activities (identify trends and potential opportunities)
- Experience in conflict resolution
- Experience executing formal change management techniques
- Experience leading process improvement initiatives without direct authority
- Experience creating and monitoring performance scorecards and/or performance metrics (KPI")
- Experience driving and executing customer focused strategies
- Demonstrated adaptability and flexibility to a rapidly moving business environment
- Bachelor's degree
- Medicare Advantage experience
- Operational healthcare experience
- SQL experience
OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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
Job Keywords: Managed Care, Operations, Client Relationship, Las Vegas, NV, Nevada