Manager, Member and Administrative Operations, Remote in WA

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together

The Member and Administrative Operations Leader is responsible for overseeing all elements of the Health Plan member experience along with assigned administrative functions including policies and procures, audit readiness, contract compliance and business continuity. While the role will give preference to candidates living in Washington and familiar with Washington Medicaid programs, this is not a requirement. This position will require limited travel to Washington (10%).

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Washington preferred. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

• Member Operations Leadership: 
  • Lead a team of professionals primarily focused on member and provider materials
  • Create and execute the member experience strategy. This includes maintaining awareness of current member sentiment, creating strategies to improve experience within budget limitations, collaborating across the health plan and UHG enterprise to execute that strategy, and monitoring outcomes to adjust future iterations of the plan
  • Maintain situational awareness of local market factors that may impact members and create and implement member engagement strategies to address
  • Responsible for state required reporting on a monthly, quarterly and annual basis
  • Create new solutions to address difficult and long-standing challenges in improving health care outcomes including development and oversight of value added benefits
  • Oversee value added benefits (VABs) for Washington Medicaid. Maintain awareness of market dynamics and member needs. Understand and communicate strategic advantage of VABs. Advocate to leadership for VABs. Partner with national procurement teams to implement VABs. Track utilization of VABs
  • Set priorities to ensure task completion and performance goals are met for Enrollment Services
  • Oversee member call center functions and member materials creation and execution, including member handbook, ID card, welcome kit materials and member website
  • Communicate any observed enrollment issues to Washington Health Care Authority (HCA) state partners and ensure the adoption of policies, processes and best practices required for success
  • Partner with UHC policy team to create member experience and enrollment advocacy strategy. Represent that strategy directly to HCA and equip other Health Plan leaders to do so
  • Maintain awareness of all contract elements related to member experience and create and execute business plans to manage those requirements
  • Responsible for all elements of member materials, including creation, HCA approval, and publication. Responsible for selected provider materials, including, but not limited to Provider Manuals
• Administrative Operations Leadership: 
  • Oversee Health Plan Policy and Procedure committee and process
  • Represent Health Plan in regulatory audits for assigned business areas
  • Partner with enterprise resiliency team to oversee Health Plan Business Continuity requirements, including simulation facilitation, recovery team contact testing, and completion of related HCA reports
  • Partner with Compliance Officer and COPA Director to lead Health Plan leaders in the creation and maintenance of contract compliance business plans

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:

• 5+ years of Medicaid experience
• 3+ years project management or strategy development and execution
• 2+ years representing Health Plan to regulators, such as HCA or other Medicaid agencies 
• 1+ years of supervisory/leadership experience with direct responsibility for managing performance of employees
• Proficiency with MS Office, which includes the ability to navigate and learn new and complex computer system applications
• Solid history of quickly gaining credibility, partnering with business leaders and exhibiting executive presence 
• Proven ability to articulate business strategies and formulate concise solutions to complex problems
• Ability to travel to Washington periodically (no more than 4 times annually)

Preferred Qualification:

• Resident of Washington and familiarity with Washington Medicaid

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

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

UnitedHealth Group 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.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.