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The Value Optimization Director provides leadership
and is responsible for the performance and results of Community and State
HealthCare Optimization targets. The Director has oversight for the Associate
Directors to assure the OBH Community and State meets/exceeds budgeted IOI by
optimizing ROI of activities focused on controlling benefit expense and
improving quality. Directs others to identify and mitigate highly complex or
unique drivers of cost of care. The Director drives programs that impact at the
Channel, regional and product levels.The goal is to identify and solve systems of care issues
that drive costs but do not add value. This includes coordination and
collaboration across both internal and external teams including but not limited
to; Optum and UHC teams and community stakeholders. The Value
Optimization lead will work in close coordination with the National Value
Optimization team to support the implementation of National initiatives at the
Product and Regional level. The Value Optimization Associate Director brings
value to the products Optum services by:
Developing strategies that helpindividuals get the right care at the right time
Mitigating adverse trends
Reducing unnecessary andineffective care
Optimizing provider performance andvalue
You’ll
enjoy the flexibility to telecommute from anywhere within the U.S. as you take
on some tough challengesPrimary Responsibilities:
Trend and Spend management: Assurethe regional/functional leads coordinate with HCE to c onduct MonthlyDeep Dive analyses for accounts. Analyses require a synthesis of severalleading indicator and claims based reports as well as benefit and regulatoryinformation that leads to the identification of drivers of adverse trend and orspend.
Oversight of the HVO Channelportfolio. Reviews all National Affordability initiatives to identify if viablestrategies are in place to address identified drivers of cost. If initiativesare not producing results determine the obstacles and works with the AssociateDirectors to develop mitigation strategies.
Oversees the development of Regionalchannel or account specific initiatives: When no initiatives are in place,based on analyses, Director has team work in close collaboration with HCE andProduct design teams to develop value models and attendant savings for HCQAIs designedto address specific adverse trends for the region, channel or account
Portfolio Management. Position willbe responsible for the management of the Community and Channel portfolio to ensureHealthcare Value Optimization targets savings are met
Communicate Healthcare ValueOptimization activities specific to the internal and external customers.Facilitate Healthcare Value Optimization management reviews at channel &market levels to communicate to stakeholders the status of accounts andprogress on mitigation strategies.
Accountabilities Include:
Serves as the Healthcare ValueOptimization Leader for Community and State
Serves as an Healthcare ValueOptimization Leader for new product development and RFPs
Resource to senior leadership
Represent Optum Healthcare ValueOptimization in relevant meetings
Collaborate with NationalAffordability team to assure national initiatives reflect Channel andRegional drivers of cost
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
5+ years working in a Managed Careenvironment
5+years of Affordability/Health Care Economics experience
3+years of direct supervisory experience leading a team
3+years working with Medicaid accounts
3+ years of Microsoft Office Suitesexperience and current proficiency with Microsoft Excel (data sorting andfiltering); Word (create documentation); PowerPoint (import objects and createdeck)
Experience working with BehavioralHealth management services; account management
Working Knowledge of BH ProviderNetworks
Demonstrated ability to achievegoals in a complex matrix environment
Demonstrated ability to workcollaboratively and manage through influence
Demonstrated strength working withproduct performance data—analytics, interpretation and customer reporting
Demonstrated ability to communicateeffectively at all levels of the organization
Preferred Qualifications:
Clinical Licensure (MSW, LICSW, LP,LMFT)
Advanced degree (e.g., MBA, MHA)
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)All
Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter
Policy.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.Job Keywords: Director, Behavioral Healthcare, Telecommute
