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Accountable Care Organization (ACO) Account Manager - Florida

UnitedHealth Group


Location:
Miami, FL
Date:
03/24/2017
Job Code:
1712282
Apply on the Company Site
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Job Details


Accountable Care Organization (ACO) Account Manager - Florida(Job Number:698063)
Description

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)

The Accountable Care Organization (ACO) Account Manager is responsible for the successful program design, compliance with network requirements, network assessment and selection, and program / product implementation. This includes enterprise-wide Clinically Integrated Network teams that focus on specific clinical area Lines of Service (e.g., Cardiology, Women's Health, Oncology, etc.) to improve the quality and affordability through improvements in appropriateness and effectiveness. Network Program Consultants may perform network analysis and strategy development and implementation; obtain data, verify validity of data, and analyze data as required, and analyze network availability and access. Other responsibilities may also include making recommendations regarding use, expansion, selection of networks for various products based on that analysis.

Primary Responsibilities:

  • Anticipate customer needs and proactively develop solutions to meet them
  • Serve as a key resource on complex and / or critical issues
  • Solve complex problems and develop innovative solutions
  • Perform complex conceptual analyses
  • Review work performed by others and provide recommendations for improvement
  • Forecast and plan resource requirements
  • Authorize deviations from standards
  • May lead functional or segment teams or projects
  • Provide explanations and information to others on the most complex issues
  • Motivate and inspire other team members
  • Provide day to day management of ACO activities, including project management,
  • problem resolution and other activities to assist in the facilitation of a successful relationship with assigned providers
  • Work effectively across lines of business and across organization including interactions with Healthcare Economics, Lines of Business Leaders, UnitedHealthcare Clinical Services, UnitedHealthcare Network, Optum, Product & Operations
  • Operate as implementation leader for assigned ACO programs
  • Responsible for completing the Business Action Plan, working across LOB and appropriate UHC resources and ACO
  • Tactical execution of the Business Action Plan to drive success of ACO
  • Interface with Senior Leadership from ACO and Health Systems to drive issues to closure and act as subject matter expert (SME) cross line of business and cross value based programs
  • Responsible for building and maintaining relationships with key stakeholders at ACOs as well as across LOB within UHC / UHN
  • Support Roster Management team including management of individual contractual triggers / conditions that may affect the relationship and timely submission of rosters per ACO Agreement
  • Ensures timeliness of data updates and data integrity for multiple ACOs per ACO Agreement
  • Ensure performance data is shared per ACO Agreement to insure ACOs understands their performance
  • Works internally across LOB?s and externally with ACO and its leadership to manage communication and meetings to insure ACO activation delivers maximum value
  • Act as SME for assigned ACOs and ensure availability to support all questions / issues which may arise on a daily basis (i.e., triaging question internal and external, tracking responses in business action plan or where appropriate)
  • Timely follow up on open issues including maintaining trackers, business action plans and other action items
  • Lead internal and external ACO meetings (clinical, data, legal, etc.) to ensure continuity and follow ups are completed
  • Accurately and effectively communicate ACO status to Director of Network Programs, Accountable Care Strategies
  • Appropriately prioritize and escalate ACO issues to Director of Network Programs, Accountable Care Strategies
  • Recommend data / report enhancements based on ACO feedback to appropriate LOB
  • Company thought leader
  • Functional SME
  • Broad business approach
  • Resource to senior leadership
  • Develops pioneering approaches to emerging industry trends
  • Project management
  • Predicts emerging customer needs and develops innovative solutions to meet them
  • Solves unique and complex problems with broad impact on the business
  • Participates in the development of business strategy
  • Develops and manages business action plans to achieve objectives
  • Leads large projects to achieve key business objectives
  • Translates highly complex concepts in ways that can be understood by a variety of audiences
  • Influences senior leadership to adopt new ideas, products, and / or approaches
  • Directs cross - functional and / or cross - segment teams
  • Accountable for the activation, implementation, management and results for ACO agreements. Responsibilities include, but are not limited to, the following:
    • Communication and coordination across various business groups and constituencies regarding ACO operations, processes, issues, and / or results
    • Analysis of data to identify trends, patterns, gaps, and opportunities
    • Business action plan development and execution
    • Early identification of issues and problem resolution
    • Manage day to day ACO activities
    • Presentations to UHN, UHC and ACO leadership

Job Network Program Mgmt
Primary Location US-FL-Miami
Other Location 
Organization UHN Southeast
Schedule Full-time
Number of Openings 1
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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