Associate Director of Operations (Claims) – San Juan, PR

For those who want to invent the future of health care, here’s your opportunity. We’re going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

The Associate Director of Operations will be to support Puerto Rico operations thru automation, productivity and quality improvements. Positions in this function include those responsible for management and administration of multiple functions, or management of general business operations. May manage the P&L of a business or part of a business unit. Manage daily operations of multiple levels of staff and multiple functions/departments across one or more business units. May include day to day site operations, management leadership internal and external to organization, accountable for financial and non-financial results (budgets and actuals). Project management and implementation, staff management.

Primary Responsibilities:

• Sets priorities on business expectation on Performance goals, Quality, Adherence, Turnaround Time, Error corrections
• Lead by example in all aspects of the business
• Lead internal management reviews, business reviews and quality reviews discussions with customers
• Participate in management appraisal cycle discussions
• Drive innovation and process improvements
• Analyze team performance and formulate action plans to address opportunities
• May be assigned to work on special projects and business initiatives
• Utilize standard project plan templates to create and/or tailor project plans to specific customers’ needs
• Assist internal and/or external business partners with completion of tasks and resolution of issues and problems with program implementation
• Establish and/or implement internal and/or external service level agreements in order to ensure ability to monitor and measure program performance (e.g., turnaround time; quality; effectiveness)
• Identify and/or secure resources (e.g., funding; staffing; system security; real estate and/or telecommuting requirements; hardware/software) required to implement programs
• Review, create, and/or maintain workflows to ensure they are up-to-date and operationally efficient
• Provide guidance, expertise, and/or assistance to internal and/or external partners (e.g., claims; call center; benefits; clinical) to ensure programs and strategies are implemented and maintained effectively
• Communicate with and help internal and/or external partners interpret contractual requirements in order to ensure effective problem solution and strategy implementation
• Ensure performance is tracked accurately utilizing internal tools and processes (e.g., dashboards; scorecards; reports)
• Request and/or receive relevant performance data from internal partners and review for accuracy
• Manipulate provided data into applicable tools and reports in order to facilitate performance review and analysis
• Review consolidated operational performance reports in order to determine overall effectiveness, make necessary changes, and identify opportunities for new programs or program consolidation or expansion
• Incorporate operations program performance information into strategic and business planning
• Utilize stakeholder input to help shape and implement continuous improvement in operational quality and financial performance (e.g., encourage participation in Six Sigma projects)
• Ensure internal partners and/or external vendors adhere to business and contractual agreements
• Conduct end-to-end testing of applicable processes, tools, procedures, and systems platforms to validate adherence to RFP/contract requirements
• Utilize relevant systems and tools to identify and/or test opportunities for efficiency improvements (e.g., parallel variable testing)
• Work with relevant internal partners (e.g., Finance; Underwriting) to identify resource requirements and/or create budgets and forecasts
• Review and assign projects/initiatives based on resource capacity, capability, and expertise
• Other duties may apply
   

*** ENGLISH PROFICIENCY ASSESSMENT WILL BE REQUIRED AFTER APPLICATION ***

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:

• Bachelor’s Degree or higher degree completed
• 10+ years of experience working with leaders in matrix organizations
• 5+ years of experience in BPO or healthcare industry
• 5+ years of experience utilizing operational metrics, data/analytics, goals/objectives, and dashboards to run, interpret, and drive business performance
• 5+ years of leadership experience
• Experience with the Microsoft Office Suite (Word, PowerPoint, Excel, and Outlook)
• Proficiency in using advanced functions in Microsoft Excel such as filters, pivot tables, formulas
• Professional proficiency in English   
• Willingness to work flexible schedules as necessary
   

Preferred Qualifications:

• Master’s Degree
• Excellent verbal and written communication skills
• Ability to work independently and make sound decisions in a fast paced environment
• Ability to multi-task
   

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.

Optum is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.