Opportunities with Optum in the Tri-State region (formerly CareMount Medical, ProHEALTH New York and Riverside Medical Group). Come make a difference in the lives of people who turn to us for care at one of our hundreds of locations across New York, New Jersey and Connecticut. Work with state-of-the-art technology and brilliant co-workers who share your passion for helping people feel their best. Join a dynamic health care organization and discover the meaning behind Caring. Connecting. Growing together.

The Optum Health East region is seeking an experienced value-based program operator to lead our Market Operations team. The Market Operations team is responsible for engaging Optum’s contracted network of medical groups, hospital systems, and post-acute partners with a goal of improving health, well-being, quality and practice performance while reducing medical costs. This position reports directly to the President of Risk Bearing Entities, Optum Health East and collaborates cross functionally with internal subject matter experts across medical management, quality, healthcare economics, risk adjustment, network development, payor contracting, and finance.

This role leads and directly oversees all aspects of external partner engagement to support population health program performance. This is a role that partners with external leaders and requires collaboration and the ability to build relationships across all levels of the organization to ensure goals are met. This role oversees both the practice performance management team, which is responsible for all aspects of frontline clinical and practice staff engagement and the network partnerships team which is responsible for engagement of external clinical, business and finance executives.

This position is accountable for the operational and financial performance of all contracted partners which includes HEDIS and STARs gap closure, complete and comprehensive clinical documentation, medical expense management, and facilitating effective onboarding and engagement of external partners to proactively identify performance improvement opportunities through the use of data analytics and technology.

If you live in Eastern Time Zone - Preferably in NY NJ CT Tri-State Area or Northeast, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• External partnership engagement and relationship management
  • Provide account leadership by serving as executive business lead and escalation point for all external operational stakeholders
  • Manage the model for engaging Optum Health East contracted participants in value-based programs to achieve performance goals
  • Collaborate with external partners to understand barriers to success and provide needed support on education, reporting and other deliverables
  • Develop solid relationships with key external stakeholders
• Effective and efficient team management
  • Review and evaluate process and outcome metrics for risk adjustment, quality and cost of care performance by market segment, and use insights to inform operating plan and performance improvement initiatives
  • Evaluate the performance of direct reports, including performance to identified standards and metrics
  • Inform and oversee staffing needs to support growth of Optum Health East partnerships o Ensure alignment and standardization of meeting approach, cadence and material preparation for all external facing value-based care content across the region
• Collaborate with cross-functional teams to ensure overall program success
  • Reduce barriers for program implementation teams, including anticipating and responding to potential roadblocks
  • Partner with medical leadership to improve IPA physician uptake of value-based concepts, programs and initiatives
  • Scope standard reporting needs/dashboards to support consistent monitoring of provider performance, vendor performance, and overall financial returns across all core operational areas
  • Actively problem solve to meet evolving challenges in a highly dynamic environment
  • Distribute performance management reporting to market leaders and synthesize information for adjustment and optimization
  • Interact with senior management by providing thoughtful analysis on key decision points to drive initiatives forward
• Emotional maturity for effective change management
  • Establish solid and lasting, trust-based relationships within team and external partners
  • Foster exemplary teamwork and strengthen a culture of continuous improvement and accountability
  • Take initiative and self-start attitude to approach problems with energy and passion
  • Demonstrate preference for working in a tight-knit team environment with diverse professional groups
• Demonstrates understanding of budgeting and forecasting tools, terminology, and processes
• Ability to influence without authority
• Ability to successfully operate in a dynamic and changing environment
• Ability to manage multiple priorities and deadlines in an expedient and decisive manner
• Innovative thought process and problem-solving skills
• Solid presentation and persuasion skills; ability to speak clearly and lead discussions with senior executives and large groups
• Solid verbal and written communication skills
• Executive level business acumen

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 10+ years of value-based program operations experience
• 5+ years of team management experience
• Reside in Eastern Time Zone with the ability to travel throughout the Northeast USA as needed for meetings and events

Preferred Qualifications:

• Payer experience as value-based program leader
• Experience in data intensive and metrics driven environment
• Knowledge of HEDIS and STARs, risk adjustment, utilization trends and medical management, medical care delivery systems, provider relations and customer service
• Understanding of healthcare finance
• Reside in NY NJ CT Tri-State area

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Connecticut, New Jersey, New York, or Rhode Island Residents Only: The salary range for this role is $147,300 to $282,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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.