If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Financial discipline and accountability count more today than ever. Which is why your performance and innovation will find a reception here like nowhere else as you help people live healthier lives while doing your life's best work.(sm)
Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is your opportunity to help write the next chapter in health care. Join us. There's never been a better time to do your life's best work. The Associate Finance Director of Medical Cost Affordability is responsible for championing, through collaboration and innovation, the health outcome and economic impact of health care interventions, policy changes and population health dynamics on Affordability strategy. This includes developing and driving medical cost containment programs, provider performance improvement strategies, and special projects that directly impact operational and financial performance using strong reporting, analytical and influencing skills.
If you are located in New York, New Jersey, Maryland or Delaware, you will have the flexibility to telecommute* as you take on some tough challenges.
- Planning and Management
- Regional and local market champion of Affordability, key driver of collaboration, decision making and conflict resolution
- Work effectively in matrix organization, be able to influence actions, demonstrate an ability to prioritize
- Manage (coordinate and facilitate) affordability meetings within the region and across stakeholders, hold team members accountable to follow through
- Create and implement (E2E) project plan and lead a project to completion
- Follow best practices “road to deployment”
- Strategize all upstream/downstream implications of change
- Strong financial acumen around affordability levers, t-shirt sizing, and assessment of opportunity viability
- Build relationships and engage broad and distinct group of stakeholders
- Be able to provide direction within the matrix (i.e. Payment Integrity, Clinical, Network, and Claims Operations) to drive execution
- Ability to influence behavior and drive strategic decision making
- Ability to strategize around concepts to identify opportunities (medical cost savings and growth) based on market requirements, research, and knowledge of network, operations, clinical, and payment integrity programs
- Collect and maintain detailed tracker of affordability initiatives (deploying, pipeline, closed and abandoned) to support monthly reporting and forecasts
- Insight oriented, continuous curiosity, willing to dig into analytics and assumptions independently
- Managed Care background
- Understand reimbursement and payment methodologies (or possess the capacity to research, learn, and apply knowledge) and work with benefit operations to understand payment logic when in question
- Network terminology (or possess the capacity to research, learn, and apply knowledge)
- Understand claims systems (CSP, COSMOS) (or possess the capacity to research, learn, and apply knowledge)
- Understand clinical / prior authorization policies (or possess the capacity to research, learn, and apply knowledge)
- Undergraduate degree
- 5+ years of experience working within a managed care organization, health insurer, or as a consultant
- 3+ years of management experience with significantly increased levels of responsibility in leadership roles and influencing strategy
- Advanced level of knowledge of managed care and network terminology and analysis
- Intermediate level of proficiency with reimbursement methodologies such as fee schedules, ASC groupers, APCs, per diems, case rates, DRGs, and AWP
- Advanced level of proficiency in Microsoft Excel, Word and Access
- Post-graduate degree preferred
- Excellent analytic and problem solving expertise
- Strong written and verbal communication skills including well-developed interpersonal skills used to influence the behavior of others, some of whom will be at executive levels
- Ability to multi-task, shifting back and forth effectively among multiple activities
Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.SM
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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: Associate Finance Director of Medical Cost Affordability, Telecommute, New York, New Jersey, Maryland or Delaware