28 days old

Sr Capability Manager - 894212

Eden Prairie, MN 55344
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  • Job Code
    894212

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)

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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.

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Sr. Capability Manager"of Solutions and Operations will be responsible for managing, 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 stakeholders"and will work closely with Director of Solutions and Operations to drive Risk"Adjustment program strategy, innovation and execution. Individual participates"in analytical, experimental, investigative and other fact-finding work in"support of solution development and may recommend changes to current Risk Adjustment"solution development procedures based on market research and new trends.

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Primary Responsibilities:
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  • Analyze"and communicate CDO Market characteristics and needs
    • Collaborate"with applicable internal stakeholders to obtain in-depth information/data about"Market needs (e.g., Risk Adjustment programs, performance, Risk transfer plans"etc.)
    • Perform/leverage"research to help establish new markets and risk transfer market needs and"trends
    • Develop"understanding of CDO/market characteristics, needs, and problems
    • Demonstrate"understanding of the comparative landscape (e.g., strengths, weaknesses, Risk"Adjustment performance gaps, program portfolios)
  • Define/Manage"Solution Strategies and Plans
    • Perform"appropriate research/analyses to help drive Risk Adjustment solution strategies"
    • Develop"functional/business specifications to drive solution planning and development
    • Define"applicable quality measures to evaluate Solution performance
    • Assess"and propose alternative solutions to support market strategies
    • Define"how we measure solution value and conduct analysis (e.g., ROI and value"methodology)
    • Identifies"and leverages solutions/tools/processes deployed in individual markets that can"be utilized at scale across the enterprise.
  • Manage/Support/Update"Products and Programs
    • Monitor"and evaluate solution performance on an ongoing basis, using applicable Risk Adjustment"performance metrics, operational metrics, and recommend appropriate action
    • Provide"consulting on proposed solution customizations, based on specific CDO or market"requirements and evolving business needs
  • Develop/Manage"Client Relationships
    • Establish"productive relationships and clear lines of communications with Market"Relations, relevant CDO stakeholders and decision-makers
    • Research,"understand and anticipate the CDOs current and future risk Adjustment needs,"challenges and strategies (e.g., leveraging industry knowledge and experience)
    • Cultivate"the CDOs perception of Clinical Performance as a trusted partner and strategic"advisor.
    • Drive"high levels of CDO satisfaction by focusing efforts on results that meet or"exceed the CDOs expectations
    • Maintain"ongoing contact with Market Relations team and CDOs to identify and address"emerging issues/concerns
  • Demonstrate"Market and Industry Knowledge
    • Stay"current on important issues in the healthcare industry.
    • Demonstrate"strong knowledge of CMS Risk Adjustment and ICD-10 coding requirements and"regulations. Stay abreast of changes/updates in relevant policies, procedures"and regulations.
    • Leverage"knowledge of the market and industry to drive service excellence and Risk"Adjustment performance.
    • Demonstrate"understanding of the market-based nuisances.
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""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:

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  • Bachelor's"degree or equivalent experience required; Master's degree preferred
  • 3+"years of Risk Adjustment experience - advanced status expected
  • 2+"years of progressive leadership experience including leading operations, and/or"business process improvement initiatives
  • Ability"to work in a matrix organization
  • Ability"to influence with and without direct management/authority
  • Technical"competency with experience creating and applying data analytics to solve"business problems
  • Superior"verbal and written communication skills
  • Superior"customer/consultant relationship management and collaboration skills
  • If you need"to enter a work site for any reason, you will be required to screen for"symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e.,"entering your symptoms via phone system) or a similar UnitedHealth"Group-approved symptom screener. When in a UnitedHealth Group building,"employees are required to wear a mask in common areas. In addition, employees"must comply with any state and local masking orders.
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Careers with Optum. Here's the"idea. We built an entire organization around one giant objective; make health"care work better for everyone. So when it comes to how we use the world's large"accumulation of health-related information, or guide health and lifestyle"choices or manage pharmacy benefits for millions, our first goal is to leap"beyond the status quo and uncover new ways to serve. Optum, part of the"UnitedHealth Group family of businesses, brings together some of the greatest"minds and most advanced ideas on where health care has to go in order to reach"its fullest potential. For you, that means working on high performance teams"against sophisticated challenges that matter. Optum, incredible ideas in one"incredible company and a singular opportunity to do your life's best"work.(sm)

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Diversity"creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity"/ Affirmative Action employer 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.

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

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""Job Keywords: Risk Adjustment, Eden Prairie, MN,"Minnesota"
Posted: 2020-11-05 Expires: 2020-12-26

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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Sr Capability Manager - 894212

UnitedHealth Group
Eden Prairie, MN 55344

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