Associate Director, Configuration Management
Associate director job at Humana
Become a part of our caring community and help us put health first The Associate Director, Service Offering Management enables and assures the management and abilities of the service offering system are controlled, balanced and aligned to the mission and needs of the whole enterprise. The Associate Director, Service Offering Management requires a solid understanding of how organization capabilities interrelate across department(s).
The Associate Director, Configuration Management enables and assures the management and abilities of the service offering system are controlled, balanced and aligned to the mission and needs of the whole enterprise. The Associate Director, Configuration Management requires a solid understanding of how organizational capabilities interrelate across department(s). This ITSM Operations position leads Configuration Management Operations (Data Quality, Governance, APM, and Discovery). This highly visible role has the following primary responsibilities:
Own the execution and continuous improvement of the IT Configuration framework including governance and control standards, processes, and procedures
Lead and define CMDB Data Quality strategic initiatives, goals, and OKR's
Support other ITSM processes such as Incident, Change, and Asset Management to consistently align to CMDB process and data requirements
Define Configuration Management Completeness, Correctness, and Compliance goals
Define CMDB Data Owner responsibility and governance standards
Drive Configuration Management Governance and Accountability initiatives across the enterprise
Identify and mange processes to close data quality gaps
Communicate effectively with business stakeholders and technical team members
Identify and drive process automation
Team building and performance management
Use your skills to make an impact
Required Qualifications
Bachelor's Degree
6 or more years of technical experience
2 or more years of management experience
Experience assessing the impact of change on service quality and SLAs.
Experience establishing metrics that can be monitored against a benchmark
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
Masters Degree
Additional Information
Work-At-Home Requirements
WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
#LI-Remote
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$129,300 - $177,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Auto-ApplyAssociate Director, GME Accreditation & Operations
Remote
The Associate Director, GME Accreditation & Operations supports the oversight, development, and continuous improvement of Graduate Medical Education (GME) programs. This role collaborates with corporate and facility GME leadership to ensure program compliance, quality, and operational excellence in alignment with Accreditation Council for Graduate Medical Education (ACGME) standards. The Manager may provide guidance for new and existing program accreditations, assists in implementing quality improvement initiatives, and offers training and support to GME staff.
Essential Functions
Collaborates with GME leadership to develop, implement, and refine processes and procedures across clinical and educational GME settings.
Provides guidance to facility GME leadership and program staff to ensure excellence in GME program operations and adherence to ACGME standards.
Assists in the development and accreditation of new GME programs, providing expertise and support in accreditation processes.
Leads or participates in quality improvement initiatives to enhance onboarding, training, and administrative skills for GME program staff.
Acts as a resource for GME program leadership, supporting a consistent and compliant approach across all programs.
Communicates effectively with corporate and facility GME teams, promoting collaboration and alignment on program goals and standards.
Monitors program compliance, assesses areas for improvement, and implements strategies to enhance operational efficiency and program quality.
Provides training and resources to program leaders and staff, as needed.
Performs other duties as assigned.
Complies with all policies and standards.
Qualifications
Bachelor's Degree in Healthcare Administration, Education, or a related field required
Master's Degree in Education, Healthcare Administration, Organizational Leadership, or Behavioral Science/Social Work preferred
4-6 years of experience in GME administration or healthcare program management required and
3-5 years of experience as a Program/Fellowship Coordinator at an ACGME-accredited program preferred
Knowledge, Skills and Abilities
Strong knowledge of GME accreditation standards, including ACGME requirements.
Excellent leadership and mentoring skills to guide GME administrative staff and program leadership.
Effective communication and interpersonal skills to foster collaboration and alignment across GME programs.
Analytical skills for program assessment, quality improvement, and compliance monitoring.
Ability to manage multiple priorities and adapt to changing regulatory and operational requirements.
Experience with GMETrack, ACGME ADS, Thalamus, New Innovations, and ERAS required.
Licenses and Certifications
Certification in GME administration or related area preferred
Auto-ApplyChief Operating Officer (COO) - SSC Sarasota
Sarasota, FL jobs
The Chief Operating Officer (COO), Shared Service Center (SSC) Sarasota, FL provides executive leadership to ensure operational efficiency, financial performance, and growth. This role is focused on the newly centralized Pre-Arrival Unit. The COO drives strategic initiatives, manages operational departments, and implements processes to achieve the mission and core values of the SSC. This role is responsible for establishing operational controls, reporting procedures, and people systems that align with the organization's objectives.
As the Chief Operating Officer (COO) at Community Health Systems (CHS) - Shared Service Center (SSC) Sarasota, FL, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical, dental and vision insurances, 401k, and a variety of other elective options
**Essential Functions**
+ Provides day-to-day leadership and management of operational departments, ensuring alignment with the SSC's mission, values, and strategic goals. This includes direct leadership over the Centralized Pre-Arrival Unit.
+ Drives the SSC to meet and exceed key performance indicators (KPIs), such as operational metrics, Net Revenue, Denials Rate, EBITDA, and Positive Cash Flow.
+ Develops, implements, and monitors operational infrastructure, including systems, processes, and personnel, to accommodate growth objectives and maintain high service standards.
+ Ensures the measurement and effectiveness of internal and external processes, providing timely, accurate, and comprehensive reports on the SSC's operational performance.
+ Leads the development, communication, and execution of growth strategies, fostering a results-oriented and accountable environment within the SSC.
+ Collaborates with the management team to establish plans for operational infrastructure, ensuring continuous improvement in efficiency and effectiveness.
+ Motivates, mentors, and leads a high-performing management team, focusing on attracting, recruiting, and retaining talent to support career development and succession planning.
+ Acts as a key liaison between the SSC, other corporate functions, and external partners to enhance collaboration, service delivery, and operational outcomes. Requires ability to engage in high-level, fast-paced dialogue with hospital C-suite members.
+ Performs other duties as assigned.
+ Maintains regular and reliable attendance.
+ Complies with all policies and standards.
+ **This is a fully remote opportunity. Some travel will be required.**
**Qualifications**
+ Bachelor's Degree in Health Administration, Business Administration, or a related field required
+ Master's Degree in Health Administration (MHA), Business Administration (MBA), or a related field preferred
+ More than 10 years of experience in operations management, with at least five (5) years in a senior leadership role required
+ 8-10 years Prior experience in a shared services environment preferred
+ Patient Access / Pre-Arrival Unit (PAU) experience, including oversight of scheduling and insurance verification for at least 2 years strongly preferred
**Knowledge, Skills and Abilities**
+ Strong understanding of shared services operations, healthcare regulations, and performance improvement methodologies.
+ Ideal candidate has COO experience from a 150+ bed hospital with a PAU under their purview.
+ Proven strategic planning, project management, and analytical skills, with a focus on operational efficiency and growth.
+ Excellent communication, leadership, and interpersonal skills, with the ability to engage and influence internal teams and external stakeholders.
+ Proficiency in operational management software, data analysis tools, and Google Suite.
+ Strong financial acumen, with experience managing budgets and optimizing resource utilization.
We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible.
Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.
Equal Employment Opportunity
This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to ************************************************* to obtain the main telephone number of the facility and ask for Human Resources.
Chief Operating Officer (COO) - SSC Sarasota
Remote
The Chief Operations Officer (COO), Shared Service Center (SSC) Sarasota, FL provides executive leadership to ensure operational efficiency, financial performance, and growth. This role is focused on the newly centralized Pre-Arrival Unit. The COO drives strategic initiatives, manages operational departments, and implements processes to achieve the mission and core values of the SSC. This role is responsible for establishing operational controls, reporting procedures, and people systems that align with the organization's objectives.
As the Chief Operations Officer (COO) at Community Health Systems (CHS) - Shared Service Center (SSC) Sarasota, FL, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical, dental and vision insurances, 401k, and a variety of other elective options
Essential Functions
Provides day-to-day leadership and management of operational departments, ensuring alignment with the SSC's mission, values, and strategic goals. This includes direct leadership over the Centralized Pre-Arrival Unit.
Drives the SSC to meet and exceed key performance indicators (KPIs), such as operational metrics, Net Revenue, Denials Rate, EBITDA, and Positive Cash Flow.
Develops, implements, and monitors operational infrastructure, including systems, processes, and personnel, to accommodate growth objectives and maintain high service standards.
Ensures the measurement and effectiveness of internal and external processes, providing timely, accurate, and comprehensive reports on the SSC's operational performance.
Leads the development, communication, and execution of growth strategies, fostering a results-oriented and accountable environment within the SSC.
Collaborates with the management team to establish plans for operational infrastructure, ensuring continuous improvement in efficiency and effectiveness.
Motivates, mentors, and leads a high-performing management team, focusing on attracting, recruiting, and retaining talent to support career development and succession planning.
Acts as a key liaison between the SSC, other corporate functions, and external partners to enhance collaboration, service delivery, and operational outcomes. Requires ability to engage in high-level, fast-paced dialogue with hospital C-suite members.
Performs other duties as assigned.
Maintains regular and reliable attendance.
Complies with all policies and standards.
This is a fully remote opportunity. Some travel will be required.
Qualifications
Bachelor's Degree in Health Administration, Business Administration, or a related field required
Master's Degree in Health Administration (MHA), Business Administration (MBA), or a related field preferred
More than 10 years of experience in operations management, with at least five (5) years in a senior leadership role required
8-10 years Prior experience in a shared services environment preferred
Patient Access / Pre-Arrival Unit (PAU) experience, including oversight of scheduling and insurance verification for at least 2 years strongly preferred
Knowledge, Skills and Abilities
Strong understanding of shared services operations, healthcare regulations, and performance improvement methodologies.
Ideal candidate has COO experience from a 150+ bed hospital with a PAU under their purview.
Proven strategic planning, project management, and analytical skills, with a focus on operational efficiency and growth.
Excellent communication, leadership, and interpersonal skills, with the ability to engage and influence internal teams and external stakeholders.
Proficiency in operational management software, data analysis tools, and Google Suite.
Strong financial acumen, with experience managing budgets and optimizing resource utilization.
We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible.
Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.
Auto-ApplyRegional Corporate IP Coding Manager - Remote based in the US
Dallas, TX jobs
Who We Are We are a community built on care. Our caregivers and supporting staff extend compassion to those in need, helping to improve the health and well-being of those we serve, and provide comfort and healing. Your community is our community. Our Story
We started out as a small operation in California. In May 1969, we acquired four hospitals, some additional care facilities and real estate for the future development of hospitals. Over the years, we've grown tremendously in size, scope and capability, building a home in new markets over time, and curating those homes to provide a compassionate environment for those entrusting us with their care.
We have a rich history at Tenet. There are so many stories of compassionate care; so many 'firsts' in terms of medical innovation; so many examples of enhancing healthcare delivery and shaping a business that is truly centered around patients and community need. Tenet and our predecessors have enabled us to touch many different elements of healthcare and make a difference in the lives of others.
Our Impact Today
Today, we are leading health system and services platform that continues to evolve in lockstep with community need. Tenet's operations include three businesses - our hospitals and physicians, USPI and Conifer Health Solutions.
Our impact spreads far and deep with 65 hospitals and approximately 510 outpatient centers and additional sites of care. We are differentiated by our top notch medical specialists and service lines that are tailored within each community we serve. The work Conifer is doing will help provide the foundation for better health for clients across the country, through the delivery of healthcare-focused revenue cycle management and value-based care solutions.
Together as an enterprise, we work to save lives and can accept nothing less than excellence from ourselves in service of our patients and their families, every day.
The Regional Corporate Coding Manager functions under the direction of the Director of Corporate Coding. Provides regional coding management oversight of coding operations for multiple Tenet Hospitals/Markets. Responsible for mentoring Corporate Coding Supervisors or Leads, Coders, DNFC Specialists, and Coding Coordinators in their roles and perform coding education and training orientation in collaboration with the Director of Coding. Performs coding quality reviews and tracks, trends, and manages coding quality performance to Tenet standard. In addition, the Regional Corporate Coding Manager ensures all facilities are properly staffed and productive in order to meet and sustain Tenet DNFC goal. Position will support Tenet corporate located in Texas.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
* Performs coding quality reviews and tracks, trends, and manages coding quality performance to Tenet standard.
* Responsible for the scheduling of Coders, DNFC Specialists, Leads, and Coding Coordinators to ensure metrics for coder productivity and DNFC are met.
* Responsible for ensuring coding team meets and maintains the Tenet standard for coding quality. Provides performance management/corrective action for productivity and quality to all direct reports.
* Responsible for mentoring Corporate Coding Supervisors or Leads, Coders, DNFC Specialists, and Coding Coordinators in their roles and perform coding education and training orientation in collaboration with the Director of Coding.
* Attends facility DNFC/B meetings and reports on DNFC performance. Accountable for DNFC performance, reporting, and follow-up to leadership.
Required:
* Associates Degree in Health Information Management or associated healthcare field of study.
* Minimum of four years of inpatient coding experience.
* One year of coding leadership experience.
* RHIT and/or CCS credential.
* Thorough knowledge of ICD- 10-CM and ICD-10-PCS coding principles associated with Official Coding Guidelines and regulatory requirements. Working knowledge of disease processes, anatomy and physiology, pharmacology, and knowledge of DRG classification and reimbursement structure.
* Effective written and verbal communication skills.
* Experience with encoders and computerized abstracting systems.
* Coding proficiency demonstrated by successful completion of Tenet coding exercise.
* Organizational skills for initiation and maintenance of efficient workflow.
* Capacity to work independently.
Preferred:
* Bachelor's Degree in Health Information Management or associated healthcare field of study.
* Five or more years of inpatient coding experience.
* Five or more years of directly leading large coding teams in a complex health system.
* RHIA and CCS
Compensation
* Pay: $85,280-$135,000 annually. Compensation depends on location, qualifications, and experience.
* Position may be eligible for an Annual Incentive Plan bonus of 10%-25% depending on role level.
* Management level positions may be eligible for sign-on and relocation bonuses.
Benefits
The following benefits are available, subject to employment status:
* Medical, dental, vision, disability, life, AD&D and business travel insurance
* Manager Time Off - 20 days per year
* Discretionary 401k match
* 10 paid holidays per year
* Health savings accounts, healthcare & dependent flexible spending accounts
* Employee Assistance program, Employee discount program
* Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance.
* For Colorado employees, paid leave in accordance with Colorado's Healthy Families and Workplaces Act
#LI-CM7
Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Tenet participates in the E-Verify program. Follow the link below for additional information.
E-Verify: *****************************
The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations.
**********
Community and State Community Initiatives Director - Ohio Market - Remote
Dublin, OH jobs
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together
UnitedHealth Group is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference?
If you are located in the state of OH, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
* In close coordination with the Population Health Director, oversee the plan's strategic design, implementation, and evaluation of population-specific improvement efforts in the context of the MCO's population health initiatives
* Oversee the plan's strategic design, implementation, and evaluation of community engagement and investment efforts in the context of the plan's population health initiatives in close coordination with the Population Health Director
* Lead and manage a team responsible for advancing community health initiatives, including oversight of staff supporting health related social needs workgroups and health outcomes related measurement execution for accreditation
* Serve as the lead for the Sponsorship Committee, overseeing strategy, evaluation, and alignment of sponsorships with community engagement priorities, population health goals, and the organization's business growth objectives. Ensure sponsorship efforts are integrated with broader community engagement strategies and investments to maximize impact and sustainability
* Inform decision-making around best payer practices to ensure optimal outcomes for all populations through provision of applicable and relevant population-specific and community-based research and resources, as well as ensuring member perspectives from all subpopulations are incorporated into the codesign of policy and service provision, including the tailoring of population-specific intervention strategies, and ensuring alignment with NCQA Health Outcomes Accreditation &/or Community-Focused Care accreditation standards and reporting requirements
* Collaborate with the MCO's Chief Information Officer to ensure the MCO collects and meaningfully uses race, ethnicity, and language data to identify opportunities for improvement
* Provide strategic guidance and facilitation to internal workgroups focused on addressing health related social needs, ensuring initiatives are data-informed, and aligned with ODM & NCQA expectations
* Coordinate and collaborate with members, providers, local and state government, community-based organizations, ODM, and other ODM-contracted managed care entities to impact differences in health outcomes at a population level
* Ensure that efforts to address poor health outcomes are codesigned with the targeted sub-populations and their providers, developed collaboratively with other ODM-contracted managed care entities to have a collective impact, and integrated with community engagement strategies and investments. Lessons learned are incorporated into future decision-making
* Designs, implements, and evaluates programs to reduce health disparities. Uses data to drive decision-making and measurement of progress
* Coordinate and collaborate with members, providers, local and state government, community-based organizations, the Ohio Department of Medicaid (ODM), and other ODM-contracted managed care entities to impact population health at the population level
* Ensure that efforts addressed at improving population health are designed collaboratively with other ODM contracted managed care entities to have a collective impact for the population and that lessons learned are incorporated into future decision-making
* Provides visionary leadership and contributes to the successful advancement of culture, population health and social responsibility principles. Responsible for being a champion of culture, cultivating innovation, and inspiring others
* Builds and deploys strategies and initiatives that identify structural impediments to disparate populations
* Demonstrates organizational agility and understands how the business operates and can identify and interpret business levers. Creates experiences that shape and grow the organizations' culture programs and capabilities
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:
* Bachelors Degree
* 5+ years of professional work experience, preferably in public health, social/human services, social work, public policy, health care, education, community development, or justice related fields
* 5+ years of experience interfacing with Senior Leadership team
* Have experience in actively applying or overseeing the application of science-based quality improvement methods to reduce differences in health outcomes
* Demonstrated community and stakeholder engagement experience
* Experience addressing health disparity concerns
* Experience and knowledge of change management principles, methodologies and tools
* Experience working with and leading cross-functional teams and projects
* Experience utilizing excellent time management, organizational, and prioritization skills and ability to balance multiple priorities
* Experience utilizing solid problem solving and analytical and skills
* Experience utilizing excellent communication skills both written and verbal
* Intermediate to advanced level of proficiency with Microsoft Word, Microsoft Project, Microsoft Excel, Visio, Microsoft PowerPoint and SharePoint
* Expert level of proficiency in Microsoft PowerPoint and Microsoft TEAMS
* Proven self-directed, independent and track record of problem solving, initiation and leadership for extremely complex, visible and multifaceted topics
* Demonstrated ability leading across organizational silos when presented with highly complex and undefined work
* Reside in Ohio
* Ability to travel up to 25% of the time, throughout the state of Ohio and limited nationwide travel
Preferred Qualifications:
* Experience working with Medicaid and/or Medicare programs
* Experience working in a matrix environment and influencing all levels of employees; inspiring others to engage, participate and act
* Proven excellent communication skills - including verbal, written, interpersonal, presentation, and facilitation skills - with a proven ability to manage conflict, resolve issues, mitigate risks and influence leaders
* All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Community and State Community Initiatives Director - Ohio Market - Remote
Dublin, OH jobs
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start **Caring. Connecting. Growing together**
UnitedHealth Group is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference?
**If you are located in the state of OH, you will have the flexibility to work remotely* as you take on some tough challenges.**
**Primary Responsibilities:**
+ In close coordination with the Population Health Director, oversee the plan's strategic design, implementation, and evaluation of population-specific improvement efforts in the context of the MCO's population health initiatives
+ Oversee the plan's strategic design, implementation, and evaluation of community engagement and investment efforts in the context of the plan's population health initiatives in close coordination with the Population Health Director
+ Lead and manage a team responsible for advancing community health initiatives, including oversight of staff supporting health related social needs workgroups and health outcomes related measurement execution for accreditation
+ Serve as the lead for the Sponsorship Committee, overseeing strategy, evaluation, and alignment of sponsorships with community engagement priorities, population health goals, and the organization's business growth objectives. Ensure sponsorship efforts are integrated with broader community engagement strategies and investments to maximize impact and sustainability
+ Inform decision-making around best payer practices to ensure optimal outcomes for all populations through provision of applicable and relevant population-specific and community-based research and resources, as well as ensuring member perspectives from all subpopulations are incorporated into the codesign of policy and service provision, including the tailoring of population-specific intervention strategies, and ensuring alignment with NCQA Health Outcomes Accreditation &/or Community-Focused Care accreditation standards and reporting requirements
+ Collaborate with the MCO's Chief Information Officer to ensure the MCO collects and meaningfully uses race, ethnicity, and language data to identify opportunities for improvement
+ Provide strategic guidance and facilitation to internal workgroups focused on addressing health related social needs, ensuring initiatives are data-informed, and aligned with ODM & NCQA expectations
+ Coordinate and collaborate with members, providers, local and state government, community-based organizations, ODM, and other ODM-contracted managed care entities to impact differences in health outcomes at a population level
+ Ensure that efforts to address poor health outcomes are codesigned with the targeted sub-populations and their providers, developed collaboratively with other ODM-contracted managed care entities to have a collective impact, and integrated with community engagement strategies and investments. Lessons learned are incorporated into future decision-making
+ Designs, implements, and evaluates programs to reduce health disparities. Uses data to drive decision-making and measurement of progress
+ Coordinate and collaborate with members, providers, local and state government, community-based organizations, the Ohio Department of Medicaid (ODM), and other ODM-contracted managed care entities to impact population health at the population level
+ Ensure that efforts addressed at improving population health are designed collaboratively with other ODM contracted managed care entities to have a collective impact for the population and that lessons learned are incorporated into future decision-making
+ Provides visionary leadership and contributes to the successful advancement of culture, population health and social responsibility principles. Responsible for being a champion of culture, cultivating innovation, and inspiring others
+ Builds and deploys strategies and initiatives that identify structural impediments to disparate populations
+ Demonstrates organizational agility and understands how the business operates and can identify and interpret business levers. Creates experiences that shape and grow the organizations' culture programs and capabilities
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:**
+ Bachelors Degree
+ 5+ years of professional work experience, preferably in public health, social/human services, social work, public policy, health care, education, community development, or justice related fields
+ 5+ years of experience interfacing with Senior Leadership team
+ Have experience in actively applying or overseeing the application of science-based quality improvement methods to reduce differences in health outcomes
+ Demonstrated community and stakeholder engagement experience
+ Experience addressing health disparity concerns
+ Experience and knowledge of change management principles, methodologies and tools
+ Experience working with and leading cross-functional teams and projects
+ Experience utilizing excellent time management, organizational, and prioritization skills and ability to balance multiple priorities
+ Experience utilizing solid problem solving and analytical and skills
+ Experience utilizing excellent communication skills both written and verbal
+ Intermediate to advanced level of proficiency with Microsoft Word, Microsoft Project, Microsoft Excel, Visio, Microsoft PowerPoint and SharePoint
+ Expert level of proficiency in Microsoft PowerPoint and Microsoft TEAMS
+ Proven self-directed, independent and track record of problem solving, initiation and leadership for extremely complex, visible and multifaceted topics
+ Demonstrated ability leading across organizational silos when presented with highly complex and undefined work
+ Reside in Ohio
+ Ability to travel up to 25% of the time, throughout the state of Ohio and limited nationwide travel
**Preferred Qualifications:**
+ Experience working with Medicaid and/or Medicare programs
+ Experience working in a matrix environment and influencing all levels of employees; inspiring others to engage, participate and act
+ Proven excellent communication skills - including verbal, written, interpersonal, presentation, and facilitation skills - with a proven ability to manage conflict, resolve issues, mitigate risks and influence leaders
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
Vice President, Population Health & Clinical Operations
Remote
Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members.
Hybrid role of working in-office and remote. Must reside in Iowa. Relocation assistance available
Position Purpose: In partnership with the CMO, serve as a key stakeholder, decision maker, and catalyst, for all market level population health identification, strategy, evaluation, and monitoring to achieve the Quadruple Aim and drive Centene's Population Health mission at the market level.
Provide strategic leadership for population health internally, as well as with providers, community organizations, advocacy groups, and applicable legislature.
Understand the local healthcare landscape to look for key drivers & opportunities for innovative models targeting the Quadruple Aim.
Understand the unique community health needs and the attributes of the populations served to drive development of programs and service.
Uses analytics to identify key insights about the populations served and drive the development of the interventions to target unique populations.
Oversees performance of all UM functions (prior authorization, concurrent review) for the market per the defined partnership agreement
Orchestrates all elements of the population health strategy for the business
Drives HBR initiatives locally through strong partnership and routine with
Partners with MDs to translate the needs of the members into intentional clinical program design that delivers successful health outcomes
Liaises with state regulators for clinical programs
Coordinates quality initiatives (audits, star ratings, contract reviews, etc) and activate enterprise and local policies•
Informs and executes against contracts (including provider contracts) - driving outcomes captured in contract and operationalizing locally
Contributing member of enterprise and local committees
Serves as an integral member of the executive leadership team, charged with delivering clinical solutions to evolving business needs
Executes on standards and customizing per local requirements while partnering with the COEs to drive continuous improvement through governance and performance monitoring.
Education/Experience: Bachelor's Degree with 5+ years of relevant experience required.
Master's Degree preferred.
Current state RN license preferred.
Pay Range: $176,900.00 - $336,600.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Auto-ApplyAssociate Director of Regional Provider Accounts - Remote Within Market
Columbus, OH jobs
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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.**
Optum OB Homecare provides holistic care to high-risk pregnant patients in the comfort of their home, and we are seeking an Associate Director of Regional Provider Markets to join our team within Optum Health to oversee the Midwest Region. In this role, you will oversee a field-based team of Account Executives responsible for cultivating and maintaining solid client relationships with providers to generate patient referrals.
We're looking for a strategic leader with a proven ability to drive business growth. The ideal candidate will bring:
+ A solid background in account management, business growth, and/or business development
+ Excellent communication and interpersonal skills
+ Financial acumen
+ Understanding of provider market trends
+ Experience managing geographically disperse team
If you are located in within one of the following markets: AZ, CA, IL, IN, KY, MI, MO, NJ, NM, NV, NY, OH, OK, PA, TN, TX, WA, you will have the flexibility to work remotely* as you take on some tough challenges.
**Primary Responsibilities:**
+ Develop and execute strategic plans to drive business retention and growth through provider relationships
+ Provide leadership, focused on employee growth, development and retention
+ Oversee Account Executives who serve as outward-facing, dedicated resource for provider accounts, with direct client contact
+ Monitor internal performance metrics to achieve business objectives at market level
+ Collaborate cross-functionally to shape and enhance our service delivery for providers
+ Translate national business strategy into regional provider action plans with measurable outcomes
+ Oversee outward-facing marketing and engagement strategies to effectively penetrate assigned territories
+ Identify regional opportunities and guide team efforts to implement with solid measures of success
+ Set and monitor KPIs and service-level quotas across region, ensuring consistent achievement of goals
+ Hire, onboard, and mentor regional team members to build a solid, capable field force
+ Foster a culture of collaboration, accountability, and continuous improvement
+ Create individualized development plans for Account Executives through regular coaching and development sessions, field co-travels and performance reviews
+ Collaborate with cross-functional teams-marketing, product, operations-to support regional initiatives
+ Oversee regional budget and resource allocation-ensuring alignment to expectations
+ Facilitate reporting and tracking on territory-level activities and develop forecasts for regional growth
+ Serve as senior point of contact for key regional clients and partners, guiding Account Executives in the development and delivery of presentations, implementations and service needs
+ Represent company and business at regional events providing education and awareness on services-such as conferences and other forums
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:**
+ 7+ years of experience in business development, sales or account management
+ 5+ years of experience in territory management capacity
+ Healthcare / business environment experience
+ Management experience, specifically with a geographically disperse team
+ Proven solid communication and presentation skills, in person and virtually, with experience interacting with clinical and non-clinical stakeholders
+ Demonstrated effective financial acumen, including budgets and quotas
+ Proven track record of success
+ Proficient use of Outlook, Word, Excel and PowerPoint
+ Ability to travel 25-50% of time
+ Reside within accountable territory: AZ, CA, IL, IN, KY, MI, MO, NJ, NM, NV, NY, OH, OK, PA, TN, TX, WA
**Preferred Qualifications:**
+ Experience calling on providers and clinical staff
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
Vice President, Clinical Operations & System Integration
Remote
Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members.
Leads the strategy and execution of technology solutions to support clinical operations, including but not limited to systems requirement gathering, monitoring and improvements. Oversees the implementation, integration, and ongoing support of clinical systems, as well as ensuring that technology effectively enables clinical staff to deliver high-quality care. Oversees and executes vision and roadmap in collaboration with clinical and technology leaders to drive enterprise-wide clinical technology initiatives and improvements.
Partners with senior leaders to ensure successful product launch, execution, and support for technology solutions.
Leads complex projects and technical innovation activities in collaboration with cross functional leaders in a matrixed environment.
Leads the SME team who provides consultation and direct testing services for all technology initiatives and implementations.
Partners with stakeholders to analyze system needs for all business operations functions, assist with system requirements, influences the design of integrated solutions, and develops integration strategies.
Implements integration solutions within the operations space, ensure thorough testing to guarantee functionality and performance, and oversees deployment.
Identifies and resolves issues related to system integration and provide technical support to end-users.
Documents integration processes, workflows, and system configurations, and provides training to relevant personnel.
Continuously monitors the performance of integrated systems, identifies areas for improvement, and optimizes system performance and reliability.
In essence, the Operations and Systems Integration role is crucial for ensuring that different systems within an organization work together efficiently and effectively, supporting overall business objectives.
Performs other duties as assigned.
Complies with all policies and standards.
Education/Experience:
Bachelor's Degree required or equivalent experience required
7+ years Strong understanding of system architecture, integration technologies, and relevant programming languages required
6+ years Ability to analyze complex technical issues, troubleshoot problems, and develop effective solutions required.
Excellent verbal and written communication skills to effectively collaborate with teams, stakeholders, and end-users required.
Ability to manage integration projects, prioritize tasks, and meet deadlines required
Adaptability to changing technologies and business needs required or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
Pay Range: $223,200.00 - $422,900.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Auto-ApplyAssociate Director Actuarial Services, UHG Trend Analytics Team - Remote - Eden Prairie, MN preferred
Eden Prairie, MN jobs
UnitedHealth Group is a health care and well-being company that's dedicated to improving the health outcomes of millions around the world. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others. Join us to start Caring. Connecting. Growing together.
The Associate Director, Actuarial Services will be a key member of the UHG Trend Analytics team, focused on developing and executing medical expense analytics and reporting (e.g. Health Cost Trend Analytics - HCTA) for Optum Care. This role is responsible for leading medical expense reporting processes using standardized and best-in-class trend methodologies to ensure consistent, accurate cost reporting across UnitedHealth Group. The ideal candidate will bring expertise in healthcare data analysis and reporting, strong collaboration skills, and at least 5 years' relevant actuarial experience.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
The Associate Director in this role will work with detailed health care claims data to build and maintain actuarial models to support medical expense reporting, analytics, and forecasting.
Primary Responsibilities:
* Lead the development and execution quarterly medical expense reporting processes for Optum Care
* Design and implement analytic methods that promote consistency with enterprise-wide medical cost reporting standards
* Develop, maintain, and enhance medical expense reports-ensuring timely delivery of actionable insights to business stakeholders
* Collaborate closely with finance, operations, and other analytic teams to drive transparency and alignment in medical trend measurement
* Analyze large healthcare datasets to identify trends, variances, and opportunities for cost management
* Present findings and recommendations clearly to both technical teams and senior leadership
* Support continuous improvement by identifying areas to automate or optimize existing processes
* Mentor junior analysts; contribute to team development initiatives
* Support ad-hoc analytic requests related to medical expense trends as needed
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 in Actuarial Science, Mathematics, Statistics, or related field
* 5+ years of actuarial experience in healthcare analytics or medical expense reporting roles
* Experience developing standard analytic methodologies
* Advanced or higher level of proficiency with data tools such as Excel/SAS/SQL/Power BI
* Demonstrated expertise with healthcare claims data analysis
* Proven excellent written and verbal communication skills; able to present technical findings effectively
Preferred Qualifications:
* Credentialed Actuary (FSA or ASA)
* Experience in Healthcare Consulting
* Experience with project management
* Proven solid organizational skills; ability to manage multiple priorities in a matrixed organization
* All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
#UHCPJ
Associate Director Actuarial - Remote
Eden Prairie, MN jobs
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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
The Associate Director, Actuarial is a key role within our OptumHealth National Actuarial and Healthcare Economics (HCE) team, responsible for overseeing, executing and communicating key actuarial functions for our Medicare Accountable Care Organizations (ACO) lines of business. This role involves managing resources and deliverables while providing customers in a risk-taking provider organization with business recommendations and contributing to the company's financial success. The successful candidate will have a solid background in actuarial science, a technical skillset to take on complex Value-Based Care (VBC) modeling and the curiosity and desire to become a thought leader in their areas.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
* Oversee, build and maintain actuarial models used for forecasting and tracking performance risks associated with Medicare ACO lines of business (ACO REACH, MSSP/Medicare Shared Saving Programs)
* Analyze revenue/claim data from multiple sources and translate complex concepts in ways that can be understood by a variety of audiences including senior leaders
* Serve as a key resource for risk-taking provider organizations and physician groups
* Communicate results and provide recommendations to stakeholders on business performance and strategic actions
* Contribute thought leadership and assist customers with evaluating and implementing new and existing Value-Based Care (VBC) programs
* Mentor, direct and review work of a team of 1-2 analysts
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 in Actuarial Science, Mathematics, or related field
* 5+ years of actuarial experience with foundational literacy in healthcare analytics and modeling
* 3+ years of experience analyzing and manipulating large healthcare claim datasets
* Proficiency in Excel and SQL
* Proven excellent problem-solving and communication skills, along with critical thinking skills to anticipate questions from key stakeholders and consider all aspects of a deliverable before completion
Preferred Qualifications:
* ASA/FSA, or progress toward ASA or FSA (Associate/Fellowship of the Society of Actuaries) designation
* Experienced with any of the following: Government Programs, Medicare Advantage (MA) products, CMS ACO/Alternative Payment Models, and/or VBC modeling
* Experience presenting business insights and summaries to inform decisions to stakeholders
* Ability to self-motivate, quickly learn new business concepts and take initiatives
* All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Associate Director Actuarial Services, UHG Trend Analytics Team - Remote - Eden Prairie, MN preferred
Eden Prairie, MN jobs
UnitedHealth Group is a health care and well-being company that's dedicated to improving the health outcomes of millions around the world. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others. Join us to start **Caring. Connecting. Growing together.**
The Associate Director, Actuarial Services will be a key member of the UHG Trend Analytics team, focused on developing and executing medical expense analytics and reporting (e.g. Health Cost Trend Analytics - HCTA) for Optum Care. This role is responsible for leading medical expense reporting processes using standardized and best-in-class trend methodologies to ensure consistent, accurate cost reporting across UnitedHealth Group. The ideal candidate will bring expertise in healthcare data analysis and reporting, strong collaboration skills, and at least 5 years' relevant actuarial experience.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
The Associate Director in this role will work with detailed health care claims data to build and maintain actuarial models to support medical expense reporting, analytics, and forecasting.
**Primary Responsibilities:**
+ Lead the development and execution quarterly medical expense reporting processes for Optum Care
+ Design and implement analytic methods that promote consistency with enterprise-wide medical cost reporting standards
+ Develop, maintain, and enhance medical expense reports-ensuring timely delivery of actionable insights to business stakeholders
+ Collaborate closely with finance, operations, and other analytic teams to drive transparency and alignment in medical trend measurement
+ Analyze large healthcare datasets to identify trends, variances, and opportunities for cost management
+ Present findings and recommendations clearly to both technical teams and senior leadership
+ Support continuous improvement by identifying areas to automate or optimize existing processes
+ Mentor junior analysts; contribute to team development initiatives
+ Support ad-hoc analytic requests related to medical expense trends as needed
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 in Actuarial Science, Mathematics, Statistics, or related field
+ 5+ years of actuarial experience in healthcare analytics or medical expense reporting roles
+ Experience developing standard analytic methodologies
+ Advanced or higher level of proficiency with data tools such as Excel/SAS/SQL/Power BI
+ Demonstrated expertise with healthcare claims data analysis
+ Proven excellent written and verbal communication skills; able to present technical findings effectively
**Preferred Qualifications:**
+ Credentialed Actuary (FSA or ASA)
+ Experience in Healthcare Consulting
+ Experience with project management
+ Proven solid organizational skills; ability to manage multiple priorities in a matrixed organization
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
**Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
_\#UHCPJ_
Associate Director Actuarial Services - Remote - Fort Washington, PA Preferred
Fort Washington, PA jobs
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start **Caring. Connecting. Growing together.**
**The Associate Director of Actuarial within UHC Medicare & Retirement will perform various analytics related to claim trends and business performance, support and help drive regulatory advocacy efforts and will complete rate filings for Medicare Supplement products.** The Associate Director will perform critical data analysis, SAS/SQL/Excel modeling, and actuarial analytics while developing and strengthening processes and models. As a subject matter expert, the Associate Director will work directly with state regulators to file and obtain state rate filing approvals.
The environment is challenging and fast-paced, requiring flexibility and curiosity. Team members are expected to have a high level of energy, a passion for driving demonstrable value at speed, and making a positive impact both within and beyond United Healthcare.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. The preferred location for this position is the Fort Washington, PA office.
**Primary Responsibilities:**
+ Participate in the end-to-end rate filing process, including preparing filings, ensuring compliance with state regulations, and working directly with state regulators in responding to questions and making recommendations to influence filing outcomes
+ Appropriately reflect pricing methodologies and assumptions within statutory filings
+ Create, modify, run and test models used to help support regulatory filing activities
+ Perform various analytics related to claim trends and business performance, support and help drive regulatory advocacy efforts
+ Assist in developing analytics that support ongoing and new advocacy efforts related to regulatory filings
+ Appropriately balance actuarial theory with practical business realities (e.g., time / resource constraints, data availability, market conditions)
+ Translate highly complex concepts in ways that can be understood by a variety of audiences including senior leaders
+ Monitor environmental factors (competitors and regulatory), anticipate and communicate impact on business to external areas, recommend solutions and influence appropriate courses of action to senior leaders
+ Collaborate with team members across the business to develop solutions to business challenges including finance, product, actuarial, and sales
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
+ ASA (Associate of the Society of Actuaries) or FSA (Fellow of the Society of Actuaries) designation
+ 6+ years of Actuarial experience in the healthcare insurance industry (pricing, claims forecasting, healthcare economics, reserving, risk management, or similar)
+ Advanced or higher level of proficiency with Excel and Access
**Preferred Qualifications:**
+ Experience working with Medicare plans (preferably Medicare Supplement)
+ Basic level of proficiency with SAS (Statistical Analysis System) and/or SQL (Structured Query Language)
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
**Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
\#UHCPJ
Associate Director Actuarial Services - Remote
Minnetonka, MN jobs
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
What's your next step? How will you leverage the study, training, certifications and your energy to help develop solutions to transform the health care industry? As an Associate Director Actuarial Services at UnitedHealth Group, you can do just that. You'll lead complex actuarial projects that have strategic importance to our mission of helping people lead healthier lives and helping to make the health system work better for everyone. It's an opportunity to help rewrite the future of UnitedHealth Group as you participate in the development of business strategy.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
* State Actuarial Pricing Lead for Commercial Group Products
* Managing the end-to-end rate filing process, including preparing filings, ensuring compliance with state regulations, and working directly with state regulators in responding to objections/inquiries
* Oversee the development of actuarial pricing models
* Develop appropriate pricing methodologies and assumptions
* Provide timely and complete Peer Reviews
* Conduct and evaluate studies on pricing, utilization and health care costs
* Proactively identify best practices and bring attention to data issues and outliers in results
* Strategic business partner with direct relationships with the health plan leadership providing actuarial support and key recommendations to matrix partners (market leadership, underwriting, sales, product)
* Monitor environmental factors (competitors and regulatory), anticipate and communicate impact on business to external areas, recommend solutions and influence appropriate courses of action to senior leaders
* Manage and develop your elite team of actuaries
* Develop presentation materials and lead communication of results to internal stakeholders
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 or equivalent work experience
* 4+ years of actuarial experience collecting, analyzing and summarizing qualitative/quantitative data
* Advanced or higher level of proficiency with Excel
* Proven clear communication skills, particularly in conveying complex topics to non-expert audiences
* Proven critical thinking skills that allow you to push through the data and find effective solutions
Preferred Qualifications:
* ASA (Associate of the Society of Actuaries) or FSA (Fellow of the Society of Actuaries) designation
* Experience working in the healthcare or finance industries
* Experience working on actuarial pricing or rate filing
* Experience managing direct reports
* Basic or higher level of proficiency with SAS (Statistical Analysis System), SQL (Structured Query Language) and/or Snowflake
* All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Corporate Real Estate Senior Director
Remote
Job Summary: The Senior Director, Global Real Estate Delivery, will oversee Cigna's global real estate transactions and projects. This role requires a strategic thinker with extensive experience in real estate markets, strong negotiation skills, and the ability to manage complex transactions across multiple regions. The Senior Director will be accountable for ensuring that all real estate projects align with the company's overall business objectives and deliver expected outcomes. Additionally, the Senior Director will have oversight of the entire real estate lifecycle, from initial market analysis to ongoing management of the projects and construction until occupancy.
Key Responsibilities:
Lead and manage all aspects of global real estate transactions, while managing outsourced service providers and an internal team.
Implement global real estate strategies that align with the company's overall business objectives.
Review market research and analysis to identify optimal opportunities for Cigna's businesses.
Negotiate and structure complex real estate transactions, ensuring the best outcomes for Cigna.
Collaborate with internal stakeholders, including finance, legal, and operations teams, to ensure alignment and support for real estate initiatives.
Manage relationships with external partners, including brokers, consultants, and legal advisors.
Oversee due diligence processes, including financial analysis, building inspections, and risk assessments.
Ensure compliance with local, national, and international regulations and standards.
Prepare and present reports to senior management on the status of real estate transactions and portfolio performance.
Assume overall accountability for the successful delivery of real estate projects, ensuring they meet scope, budget, and timeline requirements.
Monitor and evaluate the performance of real estate projects, implementing corrective actions as needed to achieve desired outcomes.
Ensure adherence to governance and compliance, providing feedback and process improvement opportunities.
Develop, leverage existing, and maintain strong internal relationships with business leaders, cross-functional team leads, and other executives.
Qualifications:
Bachelor's degree in real estate, Business Administration, Finance, or a related field. An advanced degree (MBA or equivalent) is preferred.
Minimum of 15 years of experience in real estate transactions, with a strong history in international markets.
Proven track record of successfully managing complex real estate transactions and portfolios.
Strong negotiation and analytical skills.
Excellent communication and interpersonal skills.
Ability to work effectively in a fast-paced, dynamic environment.
Proficiency in real estate software and financial modeling tools.
Desired Skills:
Strategic thinker with the ability to develop and implement long-term real estate plans.
Strong leadership and team management skills.
Knowledge of global real estate markets and trends.
Ability to manage multiple projects and priorities simultaneously.
Demonstrated ability to deliver projects on time and within budget.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 179,500 - 299,100 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus and long term incentive plan.
We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
Auto-ApplyDirector of Clinical Operations RN Hospice - Remote
Tulsa, OK jobs
Explore opportunities with [agency name], a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together.
As the Clinical Director, you will assists the Executive Director in all functions of clinical oversight of the provider. This includes oversight of the eligibility of patients referred to hospice services and services provided to patients and supervising their care; maintaining administrative practices, agency philosophy, goals, and policies which assure compliance with applicable state and federal regulations; enhancing the profitability of the agency while maintaining quality of care; and providing motivation and retention of qualified staff.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
* Compliance with all hospice regulations, laws, policies and procedures, including regulations related to the Medicare and Medicaid hospice benefit, as well as any requirements related to private or managed care insurance
* Ensures that the hospice agency employs only qualified hospice personnel
* Present on-site during business hours or immediately available by telephone when off-site conducting agency business and available after hours, as needed
* Directs the day-to-day clinical operations of the agency including training and orientation, regulatory compliance, interdisciplinary group effectiveness, growth, and education regarding hospice services
* Oversees all patient care activities to ensure compliance with current standards of accepted nursing and medical practice and regulatory standards on a constant basis
* Promotes hospice education to referral sources and the community at large
* Works closely with agency hospice physicians as well as community physicians to drive clinical excellence for patients facing end-of-life
* Ensures that patient care services are provided according to the plan of care, as ordered by the physician
* Provides clinical oversight and supervision according to licensure type, scope of practice, and state regulatory guidelines
* May participate as a member of the hospice agency Governing Body and facilitates Governing Body meetings that support review and discussion of the hospice agency activities regarding clinical care and quality oversight
* Acts as liaison between staff, patients, families, the hospice management team and the hospice Governing Body
* Provides oversight of hospice billing processes to ensure billing practices meet regulatory requirements and reflect patient care provided
* Ensures adequate staffing through recruitment and retention activities
* Ensures timely completion of assigned hospice agency staff evaluations
* Identifies education needs and ensures adequate clinical and process education for clinical staff
* Reviews monthly financials and cost management reports with Executive Director/Executive Administrator relative to all aspects of the operation to ensure that quality patient care is delivered in the most cost effective manner
* Assists with oversight of the hospice agency quality assurance performance improvement program, to include use of objective data to improve performance in the areas of improved patient/family care and activities related to patient health and safety. Specific performance improvement activities include, but are not limited to, root cause analysis and development of action plans and focused performance improvement projects
* Ensures that staff personnel files are maintained according to state and federal guidelines, as well as accreditation standards, if applicable
* Completes required courses through LHC Group learning management system and attends in-services, when applicable
* Functions as a preceptor to new hires as needed, and according to discipline-specific licensure guidelines, if applicable
* Oversees and/or directly investigates all patient complaints, and alleged or real violations involving mistreatment, neglect, or verbal, mental, sexual, and physical abuse of a patient.
* Oversees and/or directly investigates all patient-related sentinel events
* Serves as the infection control contact for the agencies, is responsible for the direction, provision, and quality of infection control services, and effectively enforces infection control practices among agencies to include infection control and isolation protocols according to the CDC, OSHA, and LHC policy
* Acts as Emergency Coordinator during emergencies ensuring appropriate plan execution
* May act as back-up to the agency Executive Director/Executive Administrator
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:
* Current and unrestricted RN licensure in the state of practice
* Current CPR certification
* Current Driver's License and vehicle insurance, and access to a dependable vehicle, or public transportation
Preferred Qualifications:
* 3+ years of experience in a hospice, home health, or other health care service delivery system setting
* 2+ years of healthcare leadership
* All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Associate Director, Quality Field Operations
Maryland Heights, MO jobs
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
This Director level is accountable for achieving assigned targets for Medicare Advantage providers in their assigned Market(s). The Director is responsible for developing and deploying business plans at the market level with a solid focus on managing CMS Risk Adjustment, Clinical Quality, HEDIS and Stars initiatives and building relationships across Market(s) to develop and optimize business opportunities and brand strength. Serving as the local Market expert, work with central function leads to target local strategies that will result in optimal Market(s) effectiveness.
You'll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
* Ensure targets are met or exceeded for assigned Market(s)
* Development and execution of clinical, RAF and quality strategy related HEDIS and Part D Stars Improvements in partnership with Medicare Market CEO, Executive Director, Data Support, and other Optum and UHC parties as appropriate
* Regular reporting and updates to senior leadership, including Health Plan CEO, CMO, and market leads, this requires development of PowerPoint and Excel data packages
* Leadership and support of achieving a minimum of 4 Star rating for assigned H contracts and for achieving 80% of our members in 4 Star or better plans
* Solid focus on employee development and employee experience
* Monitor Market level trends, risk and opportunities to continually evaluate ability to achieve established targets
* Create provider targets for direct reports and assist in territory management penetration
* Actively participate in the development and execution of site Coding Accuracy, HEDIS, (prospective and retrospective), Patient Experience and Stars strategic/business plans
* Influence the development and improvement of operations/service processes
* Drive the development and implementation of short-and-long range plans
* Continually assess market competitiveness, opportunities, and risks
* Drive initiatives to optimize Medicare Advantage payment and reimbursement strategy and capabilities
* Build and maintain collaborative relationships with Corporate, Business units within UHG and other Medicare Advantage Plans, Provider relations/Network Development, Marketing and Sales, Clinical Operations, Senior Director leadership in each market
* The Director will be accountable to ensure direct reports that oversee the field staff are performing at a high standard of performance
* Be the primary go to person for all Risk/STARS related activities within their assigned market(s) working within a matrix relationship which includes Network, Market Leads, Health Plan Medical Directors, and other Health Plan and Optum team members to assure that all STARS activities are planned and executed
* Weekly commitment of 50% travel for business meetings (including client/health plan partners and provider meetings) and 50% remote work
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:
* 5+ years of experience in a high impact role as a leader in the managed health care industry
* 5+ years of Medicare Stars experience and HEDIS experience
* Experience in the development and execution of Coding Accuracy, HEDIS (prospective and retrospective), Patient Experience and Stars strategic/business plans
* Experience developing and improving operations / service processes including short and long range plans
* Demonstrated experience on driving initiatives to optimize Medicare Advantage payment and reimbursement strategy and capabilities
* A broad base of experience across management care operations, extensive knowledge of health care industry, provider and insurance industry is required to be successful in this role
* Weekly commitment of 50% travel for business meetings (including client/health plan partners and provider meetings) and 50% remote work
Preferred Qualifications:
* Reside in the upper Midwest (Missouri / Nebraska / Iowa / Illinois )
* All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Sr Director, Client Scientific Solutions - Remote
Eden Prairie, MN jobs
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 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.
Optum AI is UnitedHealth Group's enterprise AI team. We are AI/ML scientists and engineers with deep expertise in AI/ML engineering for health care. We develop AI/ML solutions for the highest impact opportunities across UnitedHealth Group businesses including UnitedHealthcare, Optum Financial, Optum Health, Optum Insight, and Optum Rx. In addition to transforming the health care journey through responsible AI/ML innovation, our charter also includes developing and supporting an enterprise AI/ML development platform.
Optum AI team members:
* Have impact at scale: We have the data and resources to make an impact at scale. When our solutions are deployed, they have the potential to make health care system work better for everyone
* Do ground-breaking work: Many of our current projects involve cutting edge ML, NLP and LLM techniques. Generative AI methods for working with structured and unstructured health care data are continuously being developed and improved. We are working in one of the most important frontiers of AI/ML research and development
* Partner with world-class experts on innovative solutions: Our team members are developing novel AI/ML solutions to business challenges. In some cases, this includes the opportunity to file patents and publish papers about the methods we develop. We also collaborate with AI/ML researchers at some of the world's top universities
The Optum AI Sr Director, Client Scientific Solutions provides leadership for the development and deployment of applied AI/ML research and production initiatives at healthcare clients. This role leads applied research teams in developing and operationalizing advanced AI models, ensuring scalability and reliability. The Sr Director drives innovation, sets technical standards, and fosters collaboration across product and engineering teams to deliver measurable business impact.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
* Applied Research to Production: Lead applied research teams in transitioning AI models from concept to production, ensuring scalability, reliability, and cost-effectiveness. Oversee integration of research outputs into client production environments with solid governance and performance standards
* Collaboration: Partner with product and engineering leaders to translate business needs into technical solutions and foster cross-functional alignment
* Innovation Leadership: Drive adoption of advanced AI technologies and methodologies at clients deliver innovative solutions aligned with organizational priorities
* Responsible AI: Implement governance and standards for ethical AI practices, ensuring compliance and transparency in model development and deployment
* Ecosystem Development: Establish frameworks and best practices for model lifecycle management, monitoring, and continuous improvement
Talent Strategy: Mentor, develop and train senior technical leaders and build a solid pipeline of AI talent through coaching and development initiatives
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:
* Advanced degree (PhD or Master's) in Machine Learning, Artificial Intelligence, Computer Science, or related field
* 10+ years of experience in AI/ML with proven success in leading large-scale projects
* Expertise in modern AI frameworks, machine learning algorithms, and model deployment
* Experience managing senior technical teams with solid leadership and communication skills
* Hands-on experience with cloud platforms and scalable infrastructure
* Demonstrated ability to drive measurable business impact through AI solutions
* Proven commitment to Responsible AI principles
* All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $156,400 to $268,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Sr Director, Client Scientific Solutions - Remote
Eden Prairie, MN jobs
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 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.**
Optum AI is UnitedHealth Group's enterprise AI team. We are AI/ML scientists and engineers with deep expertise in AI/ML engineering for health care. We develop AI/ML solutions for the highest impact opportunities across UnitedHealth Group businesses including UnitedHealthcare, Optum Financial, Optum Health, Optum Insight, and Optum Rx. In addition to transforming the health care journey through responsible AI/ML innovation, our charter also includes developing and supporting an enterprise AI/ML development platform.
Optum AI team members:
+ Have impact at scale: We have the data and resources to make an impact at scale. When our solutions are deployed, they have the potential to make health care system work better for everyone
+ Do ground-breaking work: Many of our current projects involve cutting edge ML, NLP and LLM techniques. Generative AI methods for working with structured and unstructured health care data are continuously being developed and improved. We are working in one of the most important frontiers of AI/ML research and development
+ Partner with world-class experts on innovative solutions: Our team members are developing novel AI/ML solutions to business challenges. In some cases, this includes the opportunity to file patents and publish papers about the methods we develop. We also collaborate with AI/ML researchers at some of the world's top universities
The Optum AI Sr Director, Client Scientific Solutions provides leadership for the development and deployment of applied AI/ML research and production initiatives at healthcare clients. This role leads applied research teams in developing and operationalizing advanced AI models, ensuring scalability and reliability. The Sr Director drives innovation, sets technical standards, and fosters collaboration across product and engineering teams to deliver measurable business impact.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
**Primary Responsibilities:**
+ Applied Research to Production: Lead applied research teams in transitioning AI models from concept to production, ensuring scalability, reliability, and cost-effectiveness. Oversee integration of research outputs into client production environments with solid governance and performance standards
+ Collaboration: Partner with product and engineering leaders to translate business needs into technical solutions and foster cross-functional alignment
+ Innovation Leadership: Drive adoption of advanced AI technologies and methodologies at clients deliver innovative solutions aligned with organizational priorities
+ Responsible AI: Implement governance and standards for ethical AI practices, ensuring compliance and transparency in model development and deployment
+ Ecosystem Development: Establish frameworks and best practices for model lifecycle management, monitoring, and continuous improvement Talent Strategy: Mentor, develop and train senior technical leaders and build a solid pipeline of AI talent through coaching and development initiatives
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:**
+ Advanced degree (PhD or Master's) in Machine Learning, Artificial Intelligence, Computer Science, or related field
+ 10+ years of experience in AI/ML with proven success in leading large-scale projects
+ Expertise in modern AI frameworks, machine learning algorithms, and model deployment
+ Experience managing senior technical teams with solid leadership and communication skills
+ Hands-on experience with cloud platforms and scalable infrastructure
+ Demonstrated ability to drive measurable business impact through AI solutions
+ Proven commitment to Responsible AI principles
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $156,400 to $268,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._