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Director, Client Services

UnitedHealth Group

UnitedHealth Group, the parent organization of UnitedHealthcare and Optum, is one of the world’s leading diversified health care companies.

TELECOMMUTE WITH RESTRICTIONS: Candidates must reside in Ohio with a preferrence for the north eastern Ohio market.

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It’s an opportunity to do your life’s best work.(sm)

The Director, Client Services, has the responsibility for overseeing, developing, maintaining and servicing a high quality, and satisfied contracted provider network. Groups reporting to this position include, but are not limited to, a team of Account Managers. Key accountabilities of this position are the overall Quality and Risk Adjustment performance of the contracted network providers, strategic vision and planning, and the maintenance of a CMS adequate network. Additional duties include ensuring information and data is readily available to market staff and providers to enable them to accurately and effectively document and address member illness burden, improve quality of patient care, opportunities to reduce cost, and continually improve overall performance. The person in this position will have a strong working knowledge of key drivers of healthcare delivery, financials, total cost of care, and quality management. The Director, Client Services, helps assigned Providers operate successfully within our healthcare delivery model by providing strategic planning and tools to meet goals and builds an equally strong team to effectuate this goal throughout the contracted network. This position is expected to build and sustain strong working relationships with cross functional departments both within the organization and across other organizations including Optum, UHG, and other Care Delivery Organizations.

Primary Responsibilities:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • The responsibilities of this position demand a wide range of capabilities including: strategic planning and analysis skills; accounting knowledge and understanding of financial statements; understanding of managed care contracts; management breadth to direct and motivate; highly developed communication skills; political savvy; and the ability to develop clear action plans and drive process, given numerous issues with interdependencies
  • Analyzes data from a variety of statistical and financial reports and develops recommendations, strategic plans and action plans to improve identified deficits, barriers, and root cause issues. This position will work closely with key physician groups to develop long-term strategic relationships alongside internal departments or subject matter experts, and others as needed
  • Works throughout organization at all levels to build actionable plans and strategies that will further the mission of the organization, drive high quality execution while also driving efficiencies, and ultimately deliver better healthcare to members
  • Ensures Providers have in depth understanding of the Optum Care Model to include, but not limited to, contractual obligations, program incentives, patient care best practices, quality/HEDIS STAR, risk adjustment, growth, and total cost of care in an effort towards business goals and targets
  • Develops and maintains positive provider relationships and responsible for interpreting and explaining issues related to contracting and reimbursement. Assists internal and external customers with difficult servicing issues and researches or resolves highly complex or escalated concerns related to credentialing, claims, eligibility, utilization management, quality, and risk adjustment programs. Continuously strives to ensure that favorable relationships are maintained while ensuring the interest of the organization.
  • Drives change and innovation through continually seeking and implementing value added solutions for clients while working cross-functionally with various departments
  • Communicate and advocate providers’ needs to internal stakeholders in order to drive creation of solutions that meet our mutual business goals
  • Collaborates with leadership and regional medical director to conduct provider meetings to share and discuss economic data, identify and support best practices and escalates discrepancies for resolution, as needed
  • Assists leadership with operational implementations that include but are not limited to, building and growing an effective and high performing region, seamless onboarding of newly contracted provider groups, and developing positive provider relationships
  • Understands multiple payer relationships within market and ensures any operational issues are visible to the appropriate parties and ensures issue resolution
  • Manages direct reports to ensure they meet performance expectations, and mentor, coach, and counsel as necessary. Provides guidance in professional development activities and goals
  • Works to promote teamwork, collaboration, and implementation of best practices across all departments within the region
  • Performs all other related duties as assigned

Management Functions:

  • Assists in aligning people and projects to achieve initiatives
  • Works with direct reports to develop goals and objectives
  • Works with direct reports to establish performance standards for work assignments, monitors work status and progress including goals and objectives
  • Values cultural diversity and other individual differences in the workforce, ensuring that the organization builds on these differences
  • Ensures employees are treated in a fair and equitable manner
  • Complies with all EEO obligations and responsibilities
  • Develops staff through coaching, mentoring, rewarding, training, and guiding
  • Empowers employees and recognizes and rewards their contributions
  • Surrounds self with highly capable people. Assists in managing employee issues and resolving grievances
  • Assists to interview, hire, and orient direct reports
  • Assists in completing performance evaluations for direct reports on a timely basis
  • Notifies Manager of possible employee performance or behavior problems, may assist in disciplinary or termination process
  • Assists all staff in the interpretation of policies and procedures
  • Assesses current and future staffing needs based on organizational goals
  • Utilizes compensation data provided by Human Resources

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:

  • Bachelor’s degree Healthcare or Business Administration or a related field (8+ years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor’s degree)
  • 5+ years of provider relations or managed care experience, with an emphasis on network management, operations, financial analysis, and employee supervision
  • 4+ years of management/supervisory experience (i.e. employee selection, training, coaching, and development as well as process management)
  • Solid working knowledge of Medicare health care operations including HEDIS, HCC Coding, and Medicare Advantage
  • Solid knowledge of local provider community
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

  • Master’s Degree with a significant understanding of medical care financing and delivery systems, provider contracting, reimbursement arrangements and network management
  • Professional provider relations experience involving physicians and administrative staff
  • Provider recruitment and contracting experience
  • Presentation skills to small and large groups
  • Exceptional interpersonal skills with ability to interface effectively both internally and externally with a wide range of stakeholders, including physicians, office staff, hospital executives and other health plan staff
  • Excellent analytical and problem solving skills with effective follow through
  • Solid verbal and written communication skills

Physical Demands:
The physical demands described here are representative of those an individual must meet to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Ability to travel overnight
  • Ability to lift up to 15 pounds
  • Ability to push or pull heavy objects using up to pounds of force
  • Ability to sit for extended periods of time
  • Ability to stand for extended periods of time
  • Ability to use fine motor skills to operate office equipment and/or machinery
  • Ability to properly drive and operate a company vehicle
  • Ability to receive and comprehend instructions verbally and/or in writing
  • Ability to use logical reasoning for simple and complex problem solving

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

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)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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.

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

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Director, Client Services

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UnitedHealth Group

UnitedHealth Group, the parent organization of UnitedHealthcare and Optum, is one of the world’s leading diversified health care companies.

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