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This position is responsible for the execution for all aspects of our carve-out operating model. This role will develop strong relationships both internally across the enterprise as well as with local and regional state agency leadership to drive forward our agenda for carve-out business. The Carve-Out Program Executive Director will also be accountable for implementing strategies to deliver a better experience for bidding and implementing carve-out opportunities. This position reports to the Vice President, Government Programs.You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities:
- Develop and lead the implementation of the operational infrastructure build for our overall carve-out model. This model will address the essential gaps that are created due to the absence of a C&S health plan as with carve-in states.
- This operational structure should allow us to maintain day to day oversight of the state relationship and ensure centralized expertise of managing the carve-out space. This will also allow us to maintain a consistent operational structure behind the scenes that will help maintain efficiencies and keep overall costs down.
- This individual would be responsible for managing a team of individuals identified as being critical gap closure roles in support of carve-out bids. In addition, the state specific Executive Directors would ultimately report up to this candidate for any awarded contracts.
Key functions of the Carve-Out Program Executive Director would be to support the following activities for state awarded contracts including:
- Serve as the Interim Program Director for any newly awarded state contracts until permanent resource identified and on boarded.
- Hire, onboard and assist with training of all required state specific staff based on the contractual requirements (i.e., in state Account Manager, Dental Director, Provider Advocate, Community Based Coordinators). Cover basic operational duties covered by today’s C&S health plan until permanent staff is hired.
- Maintain the state relationship and all interactions with the state from post-bidding through implementation.
- Package and report out on all RFP deliverables to the state.
- Oversee adherence to RFP contractual requirements.
- Work with the Government Operations/Implementation Team and functional owners across the enterprise for all change management requests.
- Serve as the Program Director for the existing Rhode Island contract.
Serve as the primary liaison between all functional areas for coordinating all efforts on carve out opportunities to include prospecting, bidding/RFP activity, implementation support and ongoing account management (post implementation)
- Bachelor’s degree required
- 7+ years’ experience working within an MCO environment as a leader with responsibility for operations, clinical standard, quality management, and in a health plan organization
- 10+ years’ experience with project management, strategy development, business planning and financial/underwriting acumen
- Strong operational focus with demonstrated data analysis/interpretation acumen, project management, change management, and execution skills
- Self-motivated and able to work with little direct supervision and drive results with disciplined follow-through
- Strong strategic thinking and business acumen with the ability to align clinical and operational related strategies and recommendations with business objectives
- Solid foundational understanding of bid process, procurement cycles, and product build with a preferable knowledge base within Medicaid space
- Full knowledge of operating models within Managed Care Organizations
- Proven ability to navigate an often ambiguous and complex organization to resolve issues
- Ability to translate problems/issues and engage appropriate stakeholders to help identify impact and potential solutions
- Solid influence, collaboration and listening skills
- Solid negotiation and leadership skills
- Ability to create a strategic vision and plan its implementation
- Strong team player with ability to manage a team
- Superior verbal, written and presentation skills (both internally & externally)
- Customer-focused; able to work with and present to C-suite, state partners, consumers, and providers
Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is 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.