1+ months

Regional Medical Economics Director - Healthcare Marketplaces and Individual Exchanges - Telecommute

Minnetonka, MN 55345 Work Remotely
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Are you ready to deliver bold, business-savvy solutions to help millions live healthier lives? UnitedHealth Group is where some of the most innovative ideas in health care are created every day. As the Regional Medical Economics Director, you will lead the team performing critical research and investigating key business issues in order to find viable, real-world solutions in a complex health care landscape. You will manage a team that interprets and analyzes clinical data to proactively identify, communicate and lead organizational dialogue related to health care opportunities and risks. You'll interact with senior leadership with a focus on performance to achieve business objectives. This is where your bold ideas will write the next chapter in health care. This is the place to do your life's best work.(sm)

Positions in this function research and investigate key business problems through quantitative analyses of utilization and healthcare costs data. Provides management with statistical findings and conclusions. Identifies potential areas for medical cost improvements and alternative pricing strategies in collaboration with the Regional leadership team, key functional (clinical, network, actuarial and payment integrity) leaders and market Health Plan leaders.

If you are located in Phoenix, AZ or Minnetonka, MN, you will have the flexibility to telecommute* as you take on some tough challenges. Full-time telecommuting from other locations will be considered as well.

Primary Responsibilities:

  • Lead and direct a C&S Medical Economics team of managers and analysts including shared service business partners. The team will be dedicated to supporting Healthcare Exchange plans across the nation
  • Lead trend analytics to identify root cause issues to support the monthly clinical close process and potential remediation opportunities within Network, Payment Integrity, Clinical, and Quality
  • Develop new and innovative ways to leverage data to drive business operations in a new and growing segment
  • Work with segment finance teams and affordability leads to standardize reporting, scorecards, metric definitions and drive affordability improvements in the local markets
  • Develop tiering models (clinical performance and quality) integrating key data points from other matrix partners to evaluate network and clinical performance on a continual basis
  • Evaluate new market expansion opportunities and provide analytic support and direction to the new market teams; new market checkbook and clinical managed care assumptions
  • Support provider settlement process by analyzing exposure and developing estimates in conjunction with cross functional team including UHN, Legal, and Operations

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.

Posted: 2020-07-31 Expires: 2020-11-08

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Regional Medical Economics Director - Healthcare Marketplaces and Individual Exchanges - Telecommute

UnitedHealth Group
Minnetonka, MN 55345

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