- With guidance from the Health Plan CEO, lead the development and execution of market-specific business plans, including:
- Monitor operating effectiveness of local products/benefits
- Identify opportunities, trends and root causes to ensure operating effectiveness of local products/benefits
- Work directly with functional leads to ensure that national strategies and decisions will work effectively in the local market and/or identify adaptations needed to ensure success by representing the local market issues/viewpoints on national decisions/discussions, identifying pitfalls and concerns such as changes to a process which impacts referrals, PCP auto assignments, market risk type setup changes.
- Assist local UHN to identify and resolve operational issues associated with incentive based arrangements including: claims issues, member eligibility issues.
- Use strong local market knowledge/expertise to influence business decisions that will impact results, including benefit design, network, sales and marketing plans
- Collaborate with functional areas (e.g. Clinical, Operations, Network, Marketing, Sales) to ensure an appropriate balance between local needs and enterprise priorities and plans.
- Serve as the primary interface between assigned Markets and centralized functions, triaging issues to appropriate functional leaders for resolution (Market representative on Bed Day Management meetings for example).
- Ensure awareness of functional initiatives that will impact assigned Markets and preparing assigned Markets for changes in operating processes, systems, etc.
- Responsible for achieving market-level member experience, or Net Promoter Score (NPS) goals.
- Build community relationships with local constituencies and organizations (members, providers, community agencies/partners) that will support our ability to achieve business objectives.
- Work collaboratively with member care/customer service on member escalation issues that cannot be resolved through normal customer service channels
- Handle escalated enrollment issues that cannot be resolved through normal channels.
- Collaborate with national product and marketing to develop and execute local retention plans, including planning/coordinating local town halls and member events
- Assist in addressing local operational issues that may impact results, for example, PCP assignment issues, Member escalated complaints, provider issues
- Support product management functions, including: Accountable for local review and sign off of plan and member materials, including PBPs, provider directories, EOCs, ANOCs, ID Cards, etc.
- Ongoing education to members, providers, sales managers/agents, as well as shared services partners (e.g. UHN) and vendors related to product offerings, benefit changes and strategy
- Bachelor's degree
- 5+ years related business experience with 3+ years in health care environment
- Project management experience with strong coordination and follow-through skills
- Experience and understanding of the interdependencies across healthcare product operations (network, sales, service, systems, etc.)
- Experience utilizing a strong analytical skill set
- Master’s Degree
- Strong organizational skills that will allow individual to manage multiple tasks simultaneously to meet aggressive local goals and objectives
- Strong communication skills, both verbal and written
- Ability to display a high level of discretion, trustworthiness, honesty, compassion and passion in their business dealings with internal and external customers
- Demonstrated competence in community/public relations
- Self-motivated, goal driven with demonstrated ability to build strong community relationships with a working knowledge of the product line
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.