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 Community & State (C&S) Claim Operations Business Support Vice President is responsible for ensuring that C&S Claim Operations delivers on its contractual commitments to our state partners while focusing on an improved member and provider experience. The Vice President will be accountable for the development and execution of our strategy & roadmap for benefit configuration, change readiness & testing, business technology and business controls. This position also serves as a key advocate to minimize friction in the most important relationship in health care, which is between the member and provider. This role is accountable for modernizing and streamlining support functions that enable existing and future growth business. This position is responsible for simplifying, automating and innovating processes within C& S Operations. This role directly supports, claims processing, adjustments and appeals & grievances for all C&S markets.Primary Responsibilities: Exceed State Expectations through innovative solutions with a primary focus on improving constituent experience and regulator perceptionIntegrate preferred state implementation practices and provide recommendations to states & health plans on standard vs upgraded benefit configuration packagesDrive new issue prevention/resolution models for C&S Claim Operations leading to positive Provider NPSSimplify, automate and innovate within Claim Operations processes end-to endLead cross line of business initiatives and develop best practice modelsLeverage technology to improve speed to market delivery and increase cost savings in benefit configuration, User Acceptance Testing, Claims, Adjustments, Appeals & Grievances and Business ControlsLead and develop strategy for an internal technology group that develops end user macros to support second pass automation, through-put and qualityDevelop and implement a User Acceptance Testing Center of ExcellenceUtilize Black Belt, Project Management and Innovation resources to improve end-to-end processes in Claim OperationsDrive Claim Operations strategy and execution of growth implementations and change readiness including technology requirements. Develop scalable and repeatable processes for effective/efficient migrations and implementations and other change initiativesDirect an experienced multi-disciplined team consisting of functional subject matter experts, in configuration, requirements, testing, business technology and controlsSupport the Community and State Provider Experience which encompasses the end-to-end Claim Life CycleOverall accountability for driving strategy, capital planning and execution of Community and State Claim Operations system enhancements in benefit configuration, claims, adjustments, appeals & grievances, business controls and change readinessProvide leadership in the areas of program management, program scope definition, risk identification/mitigation, resource allocation and financial management
Required Qualifications: Bachelor's degree15+ years of increasingly responsible operations leadership experience, in the health insurance industry or another highly regulated industry10+ years leading large multi-function; multi-layered operations teams with 300+ Strong analytical skills with ability to drive transformational, consumer-centric change and manage long-term programsDemonstrated results with simplify, automating and innovating complex processesExperience with strategic, consumer-centric initiative development and implementation, including operating policies and procedures, and work process improvementsStrong verbal, written, interpersonal and presentation skills required. The proven ability to collaborate and influence internal and external business partners is essentialA proven track of building and fostering relationships at all levels of the organizationDemonstrated ability to lead and develop leadersA track record of driving high employee engagement and lowering attrition Preferred Qualifications: Deep understanding of healthcare operations and regulatory expectations of state Medicaid agencies and programs as well as CMSExperience working in a highly regulated industryMasters degree Strong operational focus with demonstrated project management, change management, and execution skillsSelf-motivated and able to work with little direct supervision and drive results with disciplined follow-thoughStrong strategic thinking and business acumen with the ability to align people related strategies and recommendations with business objectivesHigh integrity with a reputation of a trusted confidential adviser and partnerStrong decision making skills including prioritization of capital investments and business change controlsCommunicates effectively to the highest levels of leadershipCareers 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.
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.