No industry is moving faster than health care. And no organization is better positioned to lead health care forward. We need attention to every detail with an eye for the points no one has considered. The rewards for performance are significant. You'll help improve the health of millions. And you'll do your life's best work.(sm)
The health care markets are evolving in many different ways and the role and impact of the Medicaid is becoming increasingly important as health plans and providers look for new ways to grow and manage risk. In particular, the ability to manage medical cost through care management interventions or network management strategies is critical to the success of these organizations.
Optum is seeking a Director Medicaid Architecture to provide thought leadership and expertise in the Medicaid market. This position is responsible for the development of Medicaid focused consulting solutions in the all areas of LTSS, HCBS, Duals Population, Complex Care, Population Health, and provider sponsored organizations taking on risk for some of the most complex Medicaid populations.
Travel is required for this role and typically our associates leave out early Monday and return late on Thursday. Location of residence is flexible for this role; however, travel is a requirement.
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Medicaid Market Analysis and Thought Leadership:
- Industry thought leader around LTSS, Dual Eligible, Complex Care, Population health and provider sponsored organization strategies and analytics in the Medicaid market
- Provide thought leadership and insight to clients around the CMS and state specific regulations, guidelines and policies etc. around waiver programs and requirements
- Define Medicaid states market needs and gaps to current capabilities (matrix with Marketing and Sales teams)
- Define Points of View for best practices and develop key performance indicators to show value
- Work with government relations to understand regulatory opportunities/risks and align government relations with long-term marketing and delivery plan
- Identify and develop consulting offerings, products, services solutions that align with key market needs and or client initiatives
- Medicaid Program Maturity Analysis and Growth Scenario Assessments
- Client Medicaid RFP Support and Analysis
- Develop proposals and statements of work for client specific engagements
- Participate, support and complete RFI, RFP and sales process
- Complete financial analysis for proposed solutions
- Build Medicaid Marketing and Sales Collateral
Program Oversight & Service Delivery:
- Direct responsibility for the oversight, hands on participation and delivery of large scale Medicaid consulting projects/programs; large scale programs are defined as high cost, high complexity and/or high risk
- Facilitate development of business segment and enterprise level planning and program objective setting
- Participate in program funding and prioritization decision processes
- Provide strategic input to the development of program roadmap and timelines
- Create a team oriented work climate that enables professional development and encourages creative solutions and strategies
- Support the management of resources within programs
- Support program communication plan and execution
- Require that quality assurance methods are implemented within the program
- Provide status updates and review of programs to senior leadership
- Provide coaching and mentoring of project team with the goal of developing and retaining talent within the organization
- Establish trusted partner relationships to expand the Payer Consulting footprint at designated clients
- Work with client to lay out strategic roadmap for consulting solutions
- Provide financial and data analysis to support ROI for project funding
- Obtains high client satisfaction scores (>90%)
- Develop and maintain clients references
- 5+ years Management Consulting experience at the Senior Manager level
- 5+ years of Medicaid experience dealing with complex care products i.e. Duals Population, LTSS, HCBS within a consulting or payer related organization
- Experience applying a structured architecture approach and methodology for capturing the business, application information, and reference architecture views of the enterprise.
- Experience with Medicaid policy and CMS regulations and guidelines for waiver populations and programs
- Experience at the Strategy, Sr. Manager level or above within large payer organization
- Experience writing and executing business plans for new consulting solutions
- End to End knowledge of Medicaid program implementation, migration and support
- Ability to travel up to 80%, residence location is flexible
- Bachelor's degree
- Ability to create and execute SQL reports
- Knowledgeable in Medicaid Payer best practices
- Excellent presentation, writing and negotiation skills
- Experience with Agile Methodology
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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)
*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: Archtecture, Medicaid, healthcare, consulting, payer, management, consultant, telecommute, telecommuter, telecommuting, remote, work from home, OptumConsulting