30 days old

Vice President DSNP- Seattle, WA (highly preferred) or Telecommute in WA - 911150

Seattle, WA 98104 Work Remotely
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  • Job Code
    911150

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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As a member of the Leadership Team, the VP works in concert with organizational and functional area leaders to develop and implement strategic directives in support of the DSNP line of business. The VP works cross-functionally with physicians, peers and others throughout the organization to ensure the delivery of quality care and services and compliance with regulatory (CMS, HCA, NCQA), and organizational requirements. In addition, the Director shall serve as a consultant in the development and execution of a variety of operational and quality process improvement projects with company-wide impact.

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If you are located in Washington, you will have the flexibility to telecommute* as you take on some tough challenges.

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Primary Responsibilities:

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  • Consistently exhibits behavior and communication skills that demonstrate Optums commitment to superior customer service, including quality, care and concern with every internal and external customer
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  • Collaborate with the COO and functional area leaders to develop and implement a strategic plan for the line DSNP of business
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  • Provides overall direction and guidance for the DSNP line of business and works with supervisors and/or managers to communicate program objectives and vision to both internal team members and external stakeholders
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  • Works with organizational and functional area leaders in DSNP to ensure the development of goals, policies, procedures, and reporting related to the DSNP line of business align with CMS, HCA, and health plan program requirements
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  • Acts as primary liaison to health plan partners to ensure all regulatory changes are implemented as required
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  • Expertise in managing DNSP or Duals programs and partnerships. This includes the managing the multiple stakeholders resident in DNSP and Medicare Federal, State, and plan specific operations
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  • Experience and relationship in the greater Washington State market with a focus on DSNP and/or MA strongly preferred
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  • Works closely with functional areas to monitor operational reporting metrics such as resource utilization, patient satisfaction, quality, claims processing metrics, health plan data submission, service hub performance, and provider and health plan engagement to enact plans to improve efficiencies and reduce expenses
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  • Works collaboratively with the Healthcare Economics and Finance teams to identify opportunities around capitation and eligibility reconciliation and affordability
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  • Collaborates with the physician leadership to garner support for operational and quality process improvement initiatives and obtains feedback on what initiatives will be most successful and works closely to implement and monitor programs
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  • Assure contract requirements are understood by all members and that NPN is compliant with stated terms; assure continued compliance with current governmental/health care regulations
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  • Evaluate and advise on the impact of long-range planning, introduction of new programs/strategies and regulatory action
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  • Reviews, revises and amends the program requirements as required
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  • Participate in activities/organizations (local, regional, and national) and advisory and regulatory bodies, as required to maintain and maintain DSNP program compliance and improve performance for the line of business
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  • Manages direct reports to ensure that they are meeting performance expectations; mentor, coach and counsel as necessary
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  • Creates and supports an environment where improvement ideas, team-building and creative thinking are encouraged to meet the organizations needs for process improvement
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  • Develops and manages an annual departmental budget and goals
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  • Ensure compliance with all Optum policies and procedures
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  • Uses, protects, and discloses Optum patients protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
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  • Performs additional duties as assigned
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Youll 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.

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Required Qualifications:

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  • 10+ years of progressive experience in health care and/or managed care environment and/or Delivered Care for the Medicaid/Medicare Populations and/or ran advocacy programs in the Pacific Northwest
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  • Experience building and managing strong collaborative relationships with state Medicaid agencies
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  • Experience with human-centered design and primary consumer research to inform perspectives on critical needs and business opportunities
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  • Proven track record of health care policy and/or health plan leadership and development
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  • Demonstrated experience in strategic planning and product development and management
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  • Demonstrated experience in working with government officials and other external stakeholders including providers, consumer groups and/or other groups served by public benefit programs
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  • 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 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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Preferred Qualifications:

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  • Bachelorand Master s degree in business or health care
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  • Experience in overseeing, managing or supporting at a leadership level a D-SNP or MMP Plan
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  • Experience in with provider network development, and innovative risk arrangements and incentive structures
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  • Location: Telecommuter in Pacific Northwest, but willing to relocate for ideal candidate
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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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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

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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: Vice President, Health plan Operations, DSNP, Medicaid, Medicare, Public Health, Advocacy, Managed Care, Telecommute in WA

Posted: 2021-01-26 Expires: 2021-03-26

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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Vice President DSNP- Seattle, WA (highly preferred) or Telecommute in WA - 911150

UnitedHealth Group
Seattle, WA 98104

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