UnitedHealth Group Health Plan Operations Excellence Manager - Westerville, OH in Westerville, Ohio

Great sales are the result of strong purpose, conviction and pride - pride in your ability and your product. UnitedHealth Group offers a portfolio of products that are greatly improving the life of others. Bring along your passion and do your life's best work.(sm)

In this Health Plan Performance Manager role, you will be responsible to drive solid Operational performance by utilizing an Account Management approach with the C&S Health Plan. Responsibilities, included but not limited to, are: achieving and maintaining of a reference account, being a promoter of UHC Operational Excellence, developing Collaborative Relationships between the Health Plan and Shared Services, providing Thought Leadership/Innovation – across the Health Plan, C&S Functional Teams and UHC Shared Services. This role reports to the Central Region Performance Excellence and Accountability Leader with matrix accountability to Health Plan President and operations leader.

Primary Responsibilities:

  • Understanding and educating the C&S Functional Leaders and UHC Shared Services Partners

  • Learning the State Contractual / Market / Member Benefit Requirements in partnership with Compliance to assure understanding and accountability

  • Build strong relationships with matrix partners (including Claims, Member/Provider Call, Provider Operations, Appeals & Grievances, Enrollment/Eligibility, Encounters, IT, Provider / Member Experience, Clinical, Quality) by fostering and leveraging an “account team” structure that is involved in key Health Plan strategic initiatives, goals and activities

  • Ensuring matrix partner processes meet State / Market requirements by assuring that we are working within UHG and State guardrails / requirements

  • Facilitate resolution of concerns with established guardrails / requirements trying to ensure a win for both UHG and the State

  • Analyze metrics and trends to ensure contractual / market requirements are met

  • Work with matrix partners to improve performance when not met

  • Drive performance excellence and accountability by developing relationships with and working across our matrix partners to eliminate identified barriers to creating new and maintaining existing reference accounts

  • Be a trusted resource for the local Health Plan and assure that every State requirement, process, project and service has an owner within the matrix that will be most effective in execution

  • Identify opportunities for innovation, productivity improvement and savings

  • Perform special projects as assigned by Leader or Health Plan

Required Qualifications :

  • Bachelor’s degree OR equivalent years of experience

  • 3+ years in-depth managed care health plan operations experience to include, but not limited to claims, member/provider call center, enrollment and/or eligibility, and provider operations

  • 3+ years of experience managing multiple projects/tasks to meet contractual deadlines or other time sensitive commitments

  • 3+ years demonstrated experience working in a highly matrixed environment

  • 3+ years demonstrated experience managing and driving team performance

  • MS Office Suite and Visio skills at an intermediate to advanced level

Preferred Qualifications :

  • Driving distance to the Ohio office for meetings with the HP and State as applicable

  • Advanced degree

  • Experience with SharePoint

  • Experience with Six Sigma

  • Medicaid, CHIP, long term care and/or government health plan experience

  • Excellent communication skills, both written and verbal

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)

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: Operations, Manager, Health Plan, Claims, Provider, Medicaid, CHIP, Long Term Care, Government, Excellence, Westerville, Cleveland, Columbus, Cincinnati, OH, Ohio