Associate Director Market Operations

Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together.  

 

The Associate Director of Market Operations has management responsibility for day to day market operations.  The position is responsible for facilitating the creation and execution of local market strategies and action plans.  The position is involved in planning, budgeting, forecasting, facility planning and reporting for each of the assigned markets.  

 

This will include overseeing network development, network management and local office management in assigned markets.  This position may supervise multiple markets as directed.  This position has a dotted line matrix management responsibility for all other functional staff located within assigned markets – including marketing, utilization management, disease management, transportation, DataRAPS, quality and vendors.  This position works cross functionally with all other divisions in the corporation including, medical management, finance, claims, customer and member services, IT and facilities to achieve market goals and objectives.  

 

The responsibilities of this position demand a wide range of capabilities including strategic planning and analysis skills; strong accounting knowledge and understanding of financial statements; understanding of managed care contracts; management breadth to direct and motivate; highly developed communication skills; political savvy; and the ability to develop clear action plans and drive process, given often ambiguous issues with numerous interdependencies.  Analyzes data from a variety of statistical and financial reports and develops recommendations, strategic plans and action plans to improve identified financial deficits.  This position will work closely with key payor and physician groups to develop long-term strategic relationships.

 

Primary Responsibilities:

• Supervision of market personnel to include hiring, training, coaching and development to maximize staff performance and technical expertise through clearly defined objectives and leadership
• Participates in strategic and operational planning for the assigned market(s) and facilitates the execution of the plan within that assigned market
• Identifies, directs, communicates and executes continuous quality improvement activities or processes to ensure initiative outcomes are met
• Participates in development and implementation of systems that support network operations and network management
• Delegate, monitor and control work progress on key metrics, initiatives/action plans, staff productivity and administrative expenses
• Overall responsibility for the selection of additions to the primary care network. This includes creation of strategic plan, training of the staff to carry out the strategic plan, negotiation of the contract as well as overall implementation of new primary care provider groups
• Maintains effective network support services by working effectively with the Medical Director, Market Medical Director and other departments
• Handles complex and/or difficult provider inquires and/or problems and facilitates resolution of provider issues. Continuously strive to ensure that favorable relationships are maintained while ensuring the interest of the organization
• Drives change and innovation through continually seeking and implementing value added solutions for clients
• Communicate and advocate providers’ needs to internal stakeholders in order to drive creation of solutions that meet our mutual business goals
• Leads multiple individual client-focused projects and motivates cross-functional participants to improve or address systematic problems or providing value to client
• Influence or provide input to forecasting and planning activities
• Analyzes data while collaborating and/or participating in discussions with colleagues and business partners to identify potential root cause of issues
• Provide cross functional leadership across the enterprise by maintaining open communication, identifying, resolving cross functional issues, attain metric targets by collaboratively creating, maintaining, implementing and evaluating business strategic plans for each area, continually improving cross functional policies/procedures/work flows and support systems and proactively facilitates staff development to achieve the goals and objectives of the market
• Assists with and manages business projections, forecasting and budgets, both financially and with timelines, for assigned projects
• Understands payer relationships within market and ensures any operational issues are visible to the appropriate parties and ensures issue resolution
• Performs all other related duties as assigned

 

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.

Years of post-high school education can be substituted/is equivalent to years of experience.

 

Required Qualifications:

• 5+ years managed care experience with an emphasis on network management, operations, financial analysis and employee supervision
• 4+ years of management/supervisory experience (i.e. employee selection, training, coaching and development as well as process management)
• Provider contract negotiations and provider relations experience
• Solid working knowledge of Medicare health care operations including HEDIS, HCC Coding and Medicare Advantage
• Knowledge of state and federal laws relating to Medicare
• Ability and willingness to travel, both locally and non-locally, as determined by business need

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.