If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm) The Director of Post - Acute Strategy and Management will lead the national clinical and operational vision, strategy and tactics for the development and delivery of best in class clinical models, products, programs and solutions for OptumCare Care Delivery. Responsible for broad and deep knowledge of post - acute best practices (e.g., SNF, LTACH, acute rehab, home health) that optimize clinical and financial outcomes, ensure compliance with regulatory and legal requirements and support the company's overall vision, mission, strategy and goals for OptumCare's clinical models. Support program and project management in the development and rollout of robust deployment plans for the clinical models and tools that can be leveraged by the OptumCare Care Delivery Organizations.Primary Responsibilities:Lead the clinical and operational vision, strategy and tactics for the development and delivery of best in class post - acute care clinical models, products, programs and solutions that optimize clinical and financial outcomes while ensuring compliance with regulatory and legal requirementsSupport OptumCare Care Delivery Organizations in refining and adapting clinical and operational models to align with and compliment their existing programs, strategies and solutions to achieve the quadruple aim while optimizing patient quality of life and increasing patient and provider satisfaction (NPS)Provide innovative solutions to address complex clinical and operational challenges across the continuum of care with a primary focus on transition management into a post - acute setting leveraging best in class strategies and tactics to optimize outcomesAnalyze data and develop data driven strategies to create premier post - acute networks across the OptumCare Care Delivery OrganizationsPartner with Healthcare Economics, Finance and Actuarial to develop financial models and business cases for post - acute care clinical models and programsProvide subject matter expertise for end - to - end development and deployment of post - acute clinical models and programs to include risk adjustment, quality and affordabilityParticipate in regulatory and accreditation activities, as applicableWillingness and ability to travel extensively up to 50% of the time
Required Qualifications:5 years of senior leadership with responsibility for providing clinical and operational subject matter expertise directly involved in the development / implementation of post - acute care models7+ years of healthcare experience preferably in managed care5 years of experience within post - acute care analyzing data to provide cost and benefit justification, financial modeling and business case developmentMinimum of 5 years of experience managing programs with robust federal, state and accreditation requirements (e.g., CMS, NCQA, URAC)Active, unrestricted license in at least one of following: RN, APRN, or higher or LCSW or MSWTravel nationally up to 25%Preferred Qualifications:Strong knowledge of best in class care in post - acute settings (skilled nursing facilities (SNFs), Long Term Acute Care Hospitals (LTACHs), and residential and institutional settings)Broad and deep knowledge of the healthcare industry, managed care, risk models and federal (CMS) and state regulatory requirements impacting healthcareStrong knowledge and experience with Medicare, Medicare Advantage, Medicaid, Commercial and Dual Eligible plansExpertise in community based transitional interdisciplinary models, such as the VA modelSolid knowledge of product and program development methodologies and best practicesStrong knowledge of NCQA standards for care management accreditation and URAC evidence - based measures and standardsAbility to lead, manage and influence at all levels throughout the organizationStrong propensity to build and retain strong relationships with all levels throughout the organizationStrong written and verbal communication skills, with the ability to deliver complex messages Strong listening, negotiation and persuasive skillsAbility to build trust and credibility with the CMOs, MDs, Medical Management VPs and other clinical and non-clinical staffEffective product, program, project and change management skillsCareers 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)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: Healthcare, post-acute care model, managed care, costs, benefits, financial modeling, CMS, NCQA, URAC, long term acute care, risk model, government regulatory, Medicare, Medicaid,
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.