Senior Account Manager – Remote in Cleveland/Akron OH market

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

 

This position functions as a subject matter expert in Client Service operations. This position strives to bring consistency and experience to existing Client Services Account Managers in the local market by analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning. This position will organize and assist assigned provider groups and/or financial pools, as well as fellow account managers, in achieving short and long term operational/strategic business goals/ by developing, enhancing and maintaining operational information and models. They also develop and implement, in conjunction with the local Client Services Associate Director and/or Director, effective/strategic business solutions through research and analysis of data and business processes. The Senior Account Manager will develop and sustain a strong day-to-day relationship with stakeholders, the providers, and office staff to effectively implement business solutions developed by the Optum leadership team.  The Senior Account Manager is accountable for overall performance and profitability for their assigned provider groups and/or financial pools. 

 

If you are located in Cleveland or Akron, OH, you will have the flexibility to work remotely* as you take on some tough challenges.

 

Essential Job Functions:

• Analyze risk pool and/or provider group performance to determine areas of focus or improvement opportunities, to include performing analysis of financial statements and other metric-related report to determine areas of focus or improvement opportunities
• Develops strategies and create action plans that align provider pools and groups with company initiatives, goals (revenue and expense) and quality outcomes
• Drive processes and improvement initiatives that directly impact revenue, HEDIS/STAR measures and quality metrics, coding and documentation process and educational improvements
• Use and analyze data to identify trends, patterns and opportunities for the business and clients, and collaborating and/or participating in discussions with colleagues and business partners to identify potential root cause of issues
• Collaborates with internal clinical services teams, alongside Client Services leaders, to monitor utilization trends and risk pools to assist with developing strategic plans to improve performance
• Assists provider groups with investigating standard and non-standard requests and problems, to include claims and member support services
• Maintains effective support services by working effectively with the Director of Client Services, Regional Medical Director, Clinical Services team, Operations and other corporate departments
• Demonstrate understanding of providers’ business goals and strategies in order to facilitate the analysis and resolution of their issues
• Performs all other related duties as assigned

 

Primary Responsibilities:

• Support, compile and report key information
• Drive processes and technology improvement initiatives that directly impact Revenue, HEDIS/STAR measures and Quality Metrics, using standard project methodology (requirements, design, test, etc.)
• Use data to identify trends, patterns and opportunities for the business and clients. Develop business strategies in line with company strategic initiatives
• Engage provider staff and providers in analysis and evaluation of functional models and process improvements; identify dependencies and priorities
• Evaluate and drive processes, provider relationships and implementation plans
• Produce, publish and distribute scheduled and ad-hoc client and operational reports relating to the development and performance of products
• Collaborate with other Client Services leads to foster teamwork and build consistency throughout the market
• Serves as a liaison to the health plan and all customers

 

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 3+ years of experience in a related medical field or health plan setting (network management, contracting and/or recruitment, or provider relations)
• Experience communicating and facilitating strategic meetings with groups of all sizes; ability to develop long-term positive working relationships
• Experience interfacing effectively internally with all levels of staff and externally with a wide range of people including physicians, office staff, hospital executives, medical groups, IPA’s, and community organizations
• Working knowledge of Medicare health care operations including HEDIS, CMS reimbursement models, and Medicare Advantage
• Proficiency in Microsoft Word, Excel and PowerPoint
• Ability to conduct performance evaluation to identify performance measures or indicators and the actions needed to improve or correct performance, relative to the goals
• Ability and willingness to travel, both locally and non-locally, as determined by business need

 

Preferred Qualifications:

• 3+ years of healthcare management experience
• Knowledge of state and federal laws relating to Medicare
• Ability to act as a mentor to others
• Ability to work independently, use good judgment and decision-making process
• Solid business acumen, analytical, critical thinking and persuasion skills
• Ability to resolve complete problems and evaluate options to implement solutions
• Ability to adopt quickly to change in an ever-changing environment
• Solid verbal and written communication skills

 

Physical & Mental Requirements:

• Ability to lift up to 25 pounds
• Ability to sit for extended periods of time
• Ability to use fine motor skills to operate office equipment and/or machinery
• Ability to properly drive and operate a company vehicle
• Ability to receive and comprehend instructions verbally and/or in writing
• Ability to use logical reasoning for simple and complex problem solving

 

The salary range for this role is $71,600 to $140,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with al minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

 

 

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.