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VP Clinical Operations National Accounts - Remote
UnitedHealthcare
Eden Prairie, MN
Job Description
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
In the rapidly evolving health care landscape, UnitedHealth Group is optimally positioned to lead innovation and develop transformative solutions to Help People Lead Healthier Lives and Help Make the Health System Work for Everyone.
The VP of Clinical Operations, National Accounts will report to the Chief Medical Officer of National Accounts and will be responsible for ensuring streamlined activities across UnitedHealth Group that impact National Accounts based on the priorities of the CMO of National Accounts. This role will have primary accountability for the Clinical Oversight and Affordability for the A4M Premier Hubs, National Account Clinical Affordability, and handle day-to-day management of the operations team, CTG/PG and serves as the strategic advisor to the CMO for clinical affordability and operational alignment.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Oversight and management of the Clinical Strategy across the Advocate 4 Me (A4M) Premier Hubs on a global and individual client basis
Align and develop clinical strategies and focus across the HUB model
Collaborate with A4M Premier leadership and product to advance the model based on outcomes and need
Management of the Clinical Affordability Directors aligned to each HUB
Management and oversight of trend guarantee clients across NA including development of global and client specific strategies for mitigation
Claim Trend Management
Monthly reporting on CTG status – both clinical and financial
Consult and provide assistance to a broad base of Strategic Account Executives on trend management strategies including discussions with clients.
Monthly and Quarterly Reporting on key initiatives through a client-specific dashboard that are key to ongoing client performance updates
Interface and strategy development of clinical management with Optum leadership and operational teams
Cross organizational management of clinical services across UHC and Optum
Development of strategies to meet client targets and operating requirements
Day to day interface with Optum Clinical, Optum Product and UHC product on services provided to NA
Identification of operational inefficiencies and implementation of remediation plans, holding responsible party accountable
Work in close collaboration with clinical operational leadership and other key partners to prioritize, plan, structure and implement Clinical Performance
A4M (Advocate for Me) Premier Clinical Oversight:
Oversight and management Clinical Strategy for the A4M Premier Hubs
Management of the Clinical Affordability Directors aligned to each A4M Premier HUB (responsible for managing clinical performance and financial guarantees)
Overall strategy, development and management of organizational initiatives (both financial and clinical) that mitigate costs and improve trend outcomes for all A4M
HUB/CTG clients
Oversight of Trend Management/financial performance and clinical performance for Premier HUB Accounts
Work with Optum Clinical and Underwriting to set appropriate targets for Performance Guarantees and Claim Trend Guarantee management
Development of the processes and procedures for clinical management across all HUB locations – including synergies amongst the sites for clinical management that increase effectiveness
Manage EMT requests
Develop intersegment agreements
Partner with UCS to implement the BCRT process for all A4M Premier HUB clients
Assist with the development of pricing and financing methodology
Lead ongoing development of the operating model
Partner with reporting resources to develop the metrics used to monitor the performance of the A4M Premier HUBs
Primary Affordability Responsibilities:
Collaborate cross organizationally in the development, proposing and prioritization of customer solutions to reduce trend (programs, processes, benefit design, network, etc.) Works with business partners to ensure are aligned with successfully achieving savings targets
Development and execution of cross-functional strategies, projects and tactics which result in incremental, measurable medical/pharmacy cost savings for National ASO accounts
Investigate and develop new opportunities for affordability tactics by reviewing data/current FI initiatives and research for potential consideration for ASO clients.
Lead development of a business case for initiatives that can be implemented for ASO Independently analyze ASO data to determine opportunities for cost saving initiatives
Accountable for assisting AMTs with implementation of initiative that will impact medical trend for ASO National Accounts
Ownership of key ASO affordability projects. Utilize standard project plan templates incorporating enterprise wide affordability tools and road maps modifying to meet ASO requirement
Primary Organizational Roles
Business and Strategic Planning
Supports development of the strategic plan, long range plan and annual business plans in conjunction with National Account CMO providing insight and recommendations and ensuring alignment
Tracks progress against plan, identifies any deviations and suggests plans to remediate; provides reports and analysis as required
Drive UHC enterprise consolidation of forecast, long range estimates and business planning materials including summarizing key themes, tracking of critical initiatives, financial impacts and changes
Coordinate with each of the respective UHC businesses and UHG on expected deliverables, timing and current business updates
Organizational Alignment
Develop resources and tools that assist the National Account Clinical Team deliver on MBO’s, maintain a high NPS and deliver effective trend management for our clients
Performs staffing analysis and business case to support MD needs for the organization
Support the development of business cases for products and services
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:
10+ years health industry experience and/or in a large complex matrixed organization experience
7+ years of analytical skills; has hands-on experience; ability to quickly aggregate and analyze information and draw conclusions
7+ years of experience in tracking operational outcomes and providing analysis and remediation when necessary
Skills/background to understand how to communicate, position, and represent with internal and external constituents
7+ years of proficiency in analyzing and interpreting medical and financial data, with the ability to translate data into meaningful/actionable information
5+ years of experience in leadership role in the healthcare industry, successfully directing and leading multi-functional teams to include clinical
5+ years of business acumen in financial analysis, budgeting, reporting and forecasting and solid understanding of operations
5+ years of demonstrated experience in project/program management; to include managing multiple complex projects
Proven expert at strategic conceptualization both at a local level and enterprise level
Proven operational End to End thinker: broad program and delivery modality knowledge
Proven intermediate PowerPoint and Excel skills
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for this role is $147,300 to $282,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
In the rapidly evolving health care landscape, UnitedHealth Group is optimally positioned to lead innovation and develop transformative solutions to Help People Lead Healthier Lives and Help Make the Health System Work for Everyone.
The VP of Clinical Operations, National Accounts will report to the Chief Medical Officer of National Accounts and will be responsible for ensuring streamlined activities across UnitedHealth Group that impact National Accounts based on the priorities of the CMO of National Accounts. This role will have primary accountability for the Clinical Oversight and Affordability for the A4M Premier Hubs, National Account Clinical Affordability, and handle day-to-day management of the operations team, CTG/PG and serves as the strategic advisor to the CMO for clinical affordability and operational alignment.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Oversight and management of the Clinical Strategy across the Advocate 4 Me (A4M) Premier Hubs on a global and individual client basis
Align and develop clinical strategies and focus across the HUB model
Collaborate with A4M Premier leadership and product to advance the model based on outcomes and need
Management of the Clinical Affordability Directors aligned to each HUB
Management and oversight of trend guarantee clients across NA including development of global and client specific strategies for mitigation
Claim Trend Management
Monthly reporting on CTG status – both clinical and financial
Consult and provide assistance to a broad base of Strategic Account Executives on trend management strategies including discussions with clients.
Monthly and Quarterly Reporting on key initiatives through a client-specific dashboard that are key to ongoing client performance updates
Interface and strategy development of clinical management with Optum leadership and operational teams
Cross organizational management of clinical services across UHC and Optum
Development of strategies to meet client targets and operating requirements
Day to day interface with Optum Clinical, Optum Product and UHC product on services provided to NA
Identification of operational inefficiencies and implementation of remediation plans, holding responsible party accountable
Work in close collaboration with clinical operational leadership and other key partners to prioritize, plan, structure and implement Clinical Performance
A4M (Advocate for Me) Premier Clinical Oversight:
Oversight and management Clinical Strategy for the A4M Premier Hubs
Management of the Clinical Affordability Directors aligned to each A4M Premier HUB (responsible for managing clinical performance and financial guarantees)
Overall strategy, development and management of organizational initiatives (both financial and clinical) that mitigate costs and improve trend outcomes for all A4M
HUB/CTG clients
Oversight of Trend Management/financial performance and clinical performance for Premier HUB Accounts
Work with Optum Clinical and Underwriting to set appropriate targets for Performance Guarantees and Claim Trend Guarantee management
Development of the processes and procedures for clinical management across all HUB locations – including synergies amongst the sites for clinical management that increase effectiveness
Manage EMT requests
Develop intersegment agreements
Partner with UCS to implement the BCRT process for all A4M Premier HUB clients
Assist with the development of pricing and financing methodology
Lead ongoing development of the operating model
Partner with reporting resources to develop the metrics used to monitor the performance of the A4M Premier HUBs
Primary Affordability Responsibilities:
Collaborate cross organizationally in the development, proposing and prioritization of customer solutions to reduce trend (programs, processes, benefit design, network, etc.) Works with business partners to ensure are aligned with successfully achieving savings targets
Development and execution of cross-functional strategies, projects and tactics which result in incremental, measurable medical/pharmacy cost savings for National ASO accounts
Investigate and develop new opportunities for affordability tactics by reviewing data/current FI initiatives and research for potential consideration for ASO clients.
Lead development of a business case for initiatives that can be implemented for ASO Independently analyze ASO data to determine opportunities for cost saving initiatives
Accountable for assisting AMTs with implementation of initiative that will impact medical trend for ASO National Accounts
Ownership of key ASO affordability projects. Utilize standard project plan templates incorporating enterprise wide affordability tools and road maps modifying to meet ASO requirement
Primary Organizational Roles
Business and Strategic Planning
Supports development of the strategic plan, long range plan and annual business plans in conjunction with National Account CMO providing insight and recommendations and ensuring alignment
Tracks progress against plan, identifies any deviations and suggests plans to remediate; provides reports and analysis as required
Drive UHC enterprise consolidation of forecast, long range estimates and business planning materials including summarizing key themes, tracking of critical initiatives, financial impacts and changes
Coordinate with each of the respective UHC businesses and UHG on expected deliverables, timing and current business updates
Organizational Alignment
Develop resources and tools that assist the National Account Clinical Team deliver on MBO’s, maintain a high NPS and deliver effective trend management for our clients
Performs staffing analysis and business case to support MD needs for the organization
Support the development of business cases for products and services
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:
10+ years health industry experience and/or in a large complex matrixed organization experience
7+ years of analytical skills; has hands-on experience; ability to quickly aggregate and analyze information and draw conclusions
7+ years of experience in tracking operational outcomes and providing analysis and remediation when necessary
Skills/background to understand how to communicate, position, and represent with internal and external constituents
7+ years of proficiency in analyzing and interpreting medical and financial data, with the ability to translate data into meaningful/actionable information
5+ years of experience in leadership role in the healthcare industry, successfully directing and leading multi-functional teams to include clinical
5+ years of business acumen in financial analysis, budgeting, reporting and forecasting and solid understanding of operations
5+ years of demonstrated experience in project/program management; to include managing multiple complex projects
Proven expert at strategic conceptualization both at a local level and enterprise level
Proven operational End to End thinker: broad program and delivery modality knowledge
Proven intermediate PowerPoint and Excel skills
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for this role is $147,300 to $282,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
Special Notes/Instructions
Apply here: https://careers.unitedhealthgroup.com/job/20428739/vp-clinical-operations-national-accounts-remote-eden-prairie-mn/
Job Summary
Company
Employment Term and Type
Regular, Full Time
Required Education
Open
Required Experience
10+ years
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