Associate Director, Payment Integrity Market - Remote

UnitedHealth Group

  • Eden Prairie, MN
  • $110,200-188,800 per year
  • Permanent
  • Full-time
  • 1 day ago
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.You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:
  • Provide PI leadership and expertise across all integrated and non-integrated PI markets
  • Provide market-facing support & communications (H&C, Behavioral, Kelsey Seybold, CA, Facets)
  • Provide leadership over market communications to ensure program performance is understood, gross and incremental savings targets are aligned at the national and regional level
  • Lead program management for all non-integrated and integrated PI services
  • Develop PI roadmap for non-integrated markets
  • Collaborate with PI operational partner to execute on strategic initiatives
  • Work across regional businesses including local markets, medical directors, product owners, HCE and finance
  • Lead the savings reporting and forecasting communications for all PI programs across all markets
  • Develop executive presentations to communicate performance, opportunities, strategy
  • Provide vendor management, operational support and partnership with internal and external entities to ensure that the appropriate operational processes are in place and proper follow up/communications are occurring
  • Drive favorable algorithm outcomes by partnering with matrix partners to provide policy expertise which will drive market savings and medical expense reduction
  • Effectively plan staff responsibilities and manage deliverables to meet department goals and planned PI expansions
  • Lead and collaborate with UHC PI, Optum Insight PI, Optum Health PI and market stakeholders
  • Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance
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 the health care industry
  • 5+ years of working within in a payment integrity business role
  • 2+ years of experience with Medicare Advantage , Medicaid and/or commercial lines of business
  • Familiarity with product/vendor implementations
  • Intermediate knowledge of Microsoft office (outlook, word, excel, powerpoint)
  • Proficiency in various claims payment methodologies; to include capitation, fee-for-service, DRG, percent-of-charge
  • Demonstrated ability to gather and analyze information from multiple sources and use to form a cohesive and comprehensive recommendation or problem solution
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter PolicyPay 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.

UnitedHealth Group