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Utilization Management Director - Remote - State of OH
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 and start doing your life's best work.(sm) If you are located in the state of Ohio, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Oversee the plan's implementation and evaluation of utilization management based on a deep understanding utilization management principle and practice Coordinate extensively with the Ohio Department of Medicaid Regulator on policy and procedure for UnitedHealthcare's Utilization Management Program as directed by the Chief Medical Officer (CMO) Ensure timely updates of United Healthcare clinical coverage determination guidelines consistent with United Healthcare Community Plan of Ohio, Inc. Guidelines and Ohio Department of Medicaid requirements Liaison with the Ohio Department of Medicaid (ODM), the OhioRISE Plan, the single pharmacy benefits manager (SPBM) and other ODM-contracted managed care organizations on utilization management health activities as directed by the Chief Medical Officer (CMO) Running full-scale tests of change to improve utilization efficiency and performance using quality improvement science to reduce the overall rate of inappropriate denials Oversee the day-to-day operational activities of the Utilization Management Program in accordance with state guidelines Develop written policies and procedures regarding authorization of services and monitor to ensure that these are followed Ensure MCO Notices of Adverse Action are provided in accordance with 42 CFR 438.404 Ensure that the utilization management program is compliant with MHPAEA assessments 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: Ohio-licensed registered nurse, APRN, licensed independent behavioral health clinician (MD, DO, RN with advanced practice registered nurse (APRN) licensure, psychologist, licensed independent social worker (LISW), professional clinical counselor (LPSS) or a physician with a current unencumbered license through the Ohio State Medical Board with experience in the activities of utilization management, in accordance with 42 CFR 438.210 Certified Professional in Healthcare Quality Certification (CPHQ ) by the NAHQ and/or CHCQM by the American Board of Quality Assurance and Utilization Review Providers or Lean background strongly preferred. If not certified, must be willing to obtain coursework within 6 months of hire and certification within 12 months of hire or obtain equivalent training and/or certification 5+ years of progressively responsible professional experience in utilization management, service coordination, ambulatory care, community public health, case, or care management, or coordinating care across multiple setting with multiple providers 3+ years of experience providing direct behavioral health care coordination or oversight for children and adolescents with complex behavioral health needs or equivalent experience Experience in actively applying or overseeing the application of science-based quality improvement methods to reduce health disparities Experience with running / managing utilization management efforts Experience pertinent to the complex patient population(s) being managed Complex utilization management experience Experience in managed care and value-based programs Experience with cost-benefit analysis, quality assurance and continuous quality improvement processes Solid knowledge of health insurance industry utilization trends, reimbursement methods, and evolving accountable care and payment models Advanced to expert level of proficiency with MS Project, Excel, Visio, PowerPoint, TEAMS, and SharePoint Proven ability to influence and work with all levels of internal and external stakeholders/resources to move quality improvement projects and programs forward and overcome any challenges Ability to be full-time and based (working and reside) in the state of Ohio Preferred Qualifications: Master's degree or other advanced degree in nursing, social work, health services research, health policy, information technology, or other relevant field Training / Certification in quality improvement science Hands-on experience and mastery of Quality Improvement principles Healthcare and utilization management experience at the managed care plan or provider level Experience working with Medicare, Medicaid and DSNP populations and the utilization nuances of each patient population Project management or active project participation experience Tableau-BI experience Experience in quality management and quality improvement as specified in 42 CFR 438.206 through 438.370 Well-versed in with extensive experience with key-driver diagrams, flowcharts, check sheets, Pareto diagrams, cause and effect diagrams, histograms, scatter diagrams, run and control charts Skills and Abilities: Active management of multiple utilization management groups Comfortable working through ambiguity toward clarity around data specifications and sources Demonstrated ability to analyze metrics, summarize key business learning, and translate into tactical plans and report to executive level management Collaborative spirit - internal and external to the organization Flexibility in daily work schedule and task assignment Maintain a patient-focus Essential Characteristics: Ability to articulate policy and procedure to external stakeholders Ability to work well independently Ability to travel on an as-needed basis Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm) *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy 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. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. $89k-132k yearly est.4d agoDirector of Revenue Management ($117,000.00 to $150,000.00)
Under the general guidance of the General Manager, the Director of Revenue Management at 12 free nights at Hyatt hotels globally every year and 50% Discounts at our F&B outlets $117k-150k yearly11d agoManager, Partner Manager
Overview The Association of Pickleball Professionals | The APP Tour (APP) is dedicated to providing the best pickleball tournament experience for all. Background Location: Hybrid - work-from-home and office: 303 E Wacker Dr., Suite 2200, Chicago, IL $73k-116k yearly est.13d agoAmericas AFC Modelling -Platform, Systems and Technology Operations Management-Director
Deutsche Bank benefits from having a highly experienced and dedicated Anti Financial Crime (AFC) function, which performs a crucial role in keeping DBs business operations and global financial services clean from financial crime while serving the interests of the Bank and society. $200k-300k yearly8d agoDirector of Client Relationship Management - Remote
Octo offers fantastic benefits and an amazing workplace culture where you will feel valued while you perform mission critical work for our government. Octo delivers intelligent solutions and rapid results, yielding lower costs and measurable outcomes. Voted one of the region's best places to work multiple times, Octo is an employer of choice Job Description You As a Director will work with a team of engineers and customer to support the program/project management needs of a Federal client in Washington DC area. At Octo youll work beside some of the smartest and most accomplished staff youll find in your career. Company Information Octo, an IBM company, is an industry-leading, award-winning provider of technical solutions for the federal government. Our team is what makes Octo great. At Octo, we specialize in providing agile software engineering, user experience design, cloud services, and digital strategy services that address governments most pressing missions. $132k-223k yearly est.4d agoPartnership Manager (Technology, Consulting) - Remote
If you have great consulting skills and know you can consistently delight our customers and help grow our accounts, Modus is the perfect fit for you. Modus requires all team members to overlap with EST hours daily. Teach and be taught: Modus creates active teams that work in internal and external projects together, giving opportunities to stay relevant with the latest technologies and learning from experts worldwide Interact directly with internal and external clients to represent Modus and its values. Things You Might Do Modus is a fast-growing, and remote-first company, so youll likely get experience on many different projects across the organization. $63k-104k yearly est.2d agoManaging Director, Digital Media - Remote
The Managing Director will be responsible for working cross functionally across our disciplines (media, strategy, creative, data and tech), managing, mentoring, and growing the team and have full visibility and input into client financials and profitability. In addition, navigating strategic partnerships across the entirety of Publicis Groupe are key aspects to success in this role. Positioned at the core of Publicis Groupe, Epsilon is a global company with more than 8,000 employees around the world. The Managing Director of Client Development will inspire, grow, and lead an organization of client-centric professionals in all aspects of Epsilon Digital Media Solutions. $119k-257k yearly est.2d agoManager - Health Data Partnerships
Veeva's software helps our customers bring medicines and therapies to patients faster. Veeva [NYSE: VEEV] is the leader in cloud-based software for the global life sciences industry. Veeva is a Work Anywhere company which means that you can choose to work in the environment that works best for you - on any given day. As a Health Data Partnerships team member, you will be instrumental in supporting Veeva's relationships with external data partners. What You'll Do You will work to grow the data network, enabling the success of Veeva's data and analytics products and building upon a best-in-class data acquisition strategy. Represent Veeva, our data efforts, and our products in discussions - think creatively about structuring partnerships based on need when traditional approaches are not feasible. The Role Veeva Compass is the only data platform for life sciences that delivers on-demand data with the precision needed to accelerate and maximize commercial impact. $100k-160k yearly7d agoKnowledge Management and CLA Director
Bixal unites different people with different perspectives from all over the world We provide our team with an open and empowered environment where collaboration thrives and solutions flourish. Corporate Initiatives: 20% Support the Senior Practice Director in the continued adaptation and implementation of Bixal's KM and CLA strategy and vision. Serve as a thought leader and high-level representative for Bixal in the wider development community. Support learning initiatives to improve impact across the organization and support the roll-out of Bixal approaches. The Knowledge Management and CLA Director will support Bixals KM and CLA practice for USAID and other donors and clients. Bixal is a mission-driven, woman-owned small business determined to improve peoples lives through human-centered strategies and transformative technologies, with a firm belief that everyone has the right to an effective government. Business Development - 30% Capture and develop new business opportunities to expand Bixal's presence within the international MEL sector. $130k-175k yearly5d agoPartnerships & Ecosystems Manager - Remote
Your Company: As the Nonprofit Marketing Platform trusted by over 1,300 nonprofits, Feathr is purpose-built to help our customers unlock more results, time, and confidence. Drive meetings and collaboration across Feathr team and partners Seek out innovative opportunities that will generate new revenue opportunities and added value for partnerships Work closely with go-to-market teams as the primary point-of-contact for alignment on sales and/or customer opportunities with partn Were working on building an amazing culture at Feathr, where amazing people (like you) can do their best work. The Partnerships & Ecosystems Manager reports to the VP of Marketing, and will help drive better outcomes for shared customers and accelerate business growth for Feathr and our partners. $105k-115k yearly9d agoHiring Owner Operators
About Rands Trucking Rands Trucking, Inc. is a logistics and transportation company handling inbound and outbound freight deliveries with one stop or multiple stops per route. $125k-223k yearly5d agoFI Partner Manager - Remote
You will: Partner with the FI Partner Lead in supporting our largest partnerships. $5.3k monthly9d agoManager, Partner Manager (APP)
The APP, owned by Intersport, was founded in 2019 and serves professionals, senior professionals, and amateurs in the fastest growing sport in the country. Background Location: Hybrid - work-from-home and office: 303 E Wacker Dr., Suite 2200, Chicago, IL $90k-119k yearly est.18d agoManaging Director - Internal Audit
The position has become available due to the Managing Director recently having been promoted to Partner. We are currently searching for a Managing Director to join our high performing Internal Audit team in Los Angeles. $201k-214k yearly22h agoManaging Director, Digital
PLUS Communications is seeking a creative and hard-working Managing Director to join our fast-growing digital practice to help top-tier advocacy campaigns and organizations win, every day. PLUS Communications leads award-winning campaigns integrating public affairs, corporate communications, digital, advertising and media buying. Job DescriptionPLUS Communications is a full-service communications firm based in Arlington, Virginia. $108k-195k yearly est.13d agoManager of RD&D and Partnerships - Remote
Constellation has been the leader in clean energy production for more than a decade. As the nation's largest producer of clean, carbon-free energy, Constellation is a company purpose-built to meet the challenges of the climate crisis. Constellation offers customers a range of clean, zero-carbon energy solutions to help reduce their carbon footprint and achieve their sustainability goals. Constellation has been the leader in carbon-free energy production for more than a decade, and generates 50% more clean, carbon-free electricity than any other company in America. Constellation will provide you the tools and resources you need to design, build and power a successful career. * Strategic partner engagement to support emerging technology collaborations between Constellation and the external innovation ecosystem. The race is on to confront the climate crisis and Constellation is ready to meet the challenge. Constellation offers a wide range of benefits, designed to help our employees thrive professionally and personally. $124.2k-138k yearly1d agoDirector, Managing Director- 401K Relationship Manager- NATIONWIDE/WORK FROM HOME
* Working closely and actively leads discussions with Investment Consulting to build effective investment strategies and develop solutions that benefit clients/Fidelity in partnership with the Plan's Advisors. In this role you will develop positive relationships with institutional clients and build internal working relationships with Fidelity personnel in support of service delivery. The Managing Director (MD) is entrusted with a book of business of defined contribution plans comprised of 25 - 35 client relationships that may range $20 - 100M in assets under administration. The Managing Director is the primary contact for the client and works in a team structure which is collectively responsible for leading, educating, resolving client issues, establishing relationships and meeting the needs of both Plan Sponsors and Advisors. * Accurately planning, influencing, and implementing Fidelity solutions to address needs. $106k-202k yearly est.60d+ agoEntry-Level Business Operations Role
Year Up participants also receive an educational stipend. Year Up is a one-year or less, intensive job training program that provides young adults with hands-on skill development, corporate internships, and coursework eligible for college credit. You can apply to Year Up if you are: 80% of Year Up graduates are employed and/or enrolled in postsecondary education within 4 months of graduation. $52k yearly7d agoManaging Director (Remote Available)
Ideally the candidate would be based in Washington, DC, although alternative locations will be considered. Basic Function: The Managing Director will lead operational excellence and drive strategic direction for Aspen Digital as it realigns its processes and practices following a period of rapid growth in staff and programming. Headquartered in Washington, DC, the Institute has a campus in Aspen, Colorado, and an international network of partners. Essential Duties and Responsibilities: Strategic Leadership and Operational Management The Managing Director, working closely with the Executive Director, the Aspen Digital leadership team, and program teams, manages the operational and strategic direction of the program on a day-to-day basis. Job DescriptionThe Aspen Institute The Aspen Institute is a global nonprofit organization committed to realizing a free, just, and equitable society. A program of the Aspen Institute, we bring together thinkers and doers from around the world to uncover new ideas and create outcomes that empower communities and strengthen democracy. $166k-254k yearly est.2d agoManaging Director, Digital
FP1 Strategies is seeking a creative and hard-working Managing Director to join our fast-growing digital practice to help top-tier political campaigns and advocacy organizations win, every day. Job DescriptionFP1 Strategies is a political consulting firm based in Arlington, Virginia specializing in coalition building, grassroots mobilization, advertising, digital engagement and message development. $130k-227k yearly est.13d ago
Learn More About Managing Owner Jobs
Average Salary For a Managing Owner
Based on recent jobs postings on Zippia, the average salary in the U.S. for a Managing Owner is $111,101 per year or $53 per hour. The highest paying Managing Owner jobs have a salary over $184,000 per year while the lowest paying Managing Owner jobs pay $66,000 per year
Updated June 4, 2023
Average Managing Owner Salary
$120,703 yearly
$53 hourly
5 Common Career Paths For a Managing Owner
Owner
Owners, in the most basic sense, own the business, company, or organization. They are responsible for building the business. They create business plans and the general vision and mission of the company, set goals, work on these goals, and ensure that the business keeps running. They manage all aspects of their business, from finances to marketing to people, etc. When the business becomes stable, owners eventually hire more employees. As such, owners also become overseers who would ensure that the organization remains afloat.
Project Manager
Project managers oversee a specific project related to the organization's business. They manage the whole project from inception to evaluation. They initiate planning with involved departments, follow-through on the plans, ensure smooth execution of the plans, and evaluate the project for further improvements should these be needed. In line with this, project managers also ensure that the project is cost-efficient and well within the budget. They also manage the different work teams involved in the project and ensure that things are running smoothly on this aspect as well.
Owner/Manager
Owners/managers are responsible for establishing a business and managing the operations once the business is running. They plan and make sure that the company has adequate financing. They also handle the initial marketing to get customers. Owners/mangers handle human resources activities, such as hiring and training employees. Once the business has launched, they start delegating activities to other employees and may also start assigning leaders to different departments. However, they still oversee the whole operation. Owners/managers are the top decision-makers and ensure that business strategies align with the goals.
Property Manager
Property managers are responsible for overseeing the real estate properties of their clients. They manage property rentals and leasing and ensure that the terms on these rentals are by what the owner is amenable to. Property managers act as the representative of their client during negotiations and deals. They also set rental prices and other finance-related items since they are familiar with how the market looks. Besides dealing with financial matters, they also manage administrative matters such as enforcing rules and policies, crafting reports, managing contractors, and drafting related documents.
Operations Manager
Operations managers are in charge of running the main business of the organization. They ensure that the business is running smoothly from an operations standpoint. They make sure that the processes in place produce the necessary output by implementing quality control measures. They also manage finances and ensure that there is enough budget to keep the operations of the business running. They also ensure that the production of goods or services is cost-efficient. Operations managers also handle people-related concerns. They are responsible for interviewing candidates, choosing the ones to hire, and ensuring that individuals assigned to operations are properly trained.
Illustrated Career Paths For a Managing Owner
Managing Owner