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Director Member Operations - Medicare DSNP - VA Telecommute

UnitedHealth Group

Richmond, VA
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Job Details

743908 Director Member Operations Medicare DSNP VA Telecommute

Director Member Operations - Medicare DSNP - VA Telecommute (743908)

Position Description

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm)


Reporting to the COO, this Senior Leadership position directs the strategic development, growth and operations in providing innovative care Medicare Duals, individuals who qualify for both Medicare and Medicaid. Overall goals of this position are to meet revenue, membership, and operating income objectives, improve operations and processes, develop appropriate provider networks / contracting strategies , foster key internal and external business relationships, and create a successful, collaborative team of people to achieve these goals in assigned markets.


If you are located in Richmond, VA, you will have the flexibility to telecommute* as you take on some tough challenges.


Primary Responsibilities:

  • Overall Responsibility for program operations and P&L for VA Medicare DSNP LOB
  • Help, develop and support the strategic relationship with State agencies and stakeholders to influence program policies and operations, understand and predict key policy initiatives, and enhance their satisfaction with United HealthCare as a key strategic partner for improving the health and well - being of membership
  • Direct and effectively develop strategic goals into specific operating and business plans and decisions
  • Develop the appropriate product, marketing and operating strategy to maximize revenue and profit across the product portfolio
  • Develop marketing plans to enhance company and product awareness, support the sales team to maximize gross adds, optimize our service area, develop collaborative relationships with key partners to enhance revenue
  • Through collaboration with Corporate Clinical Services, provide for the appropriate coordination and delivery of medical care within the benefit structure
  • Responsible for all network strategy including network development, service area expansion, contracting, provider relations, and relationships with the UHC contracting function
  • Manage and facilitate programmatic initiatives to enhance STAR ratings
  • Manage and direct the personal ‘concierge’ team supporting retention activities and reduction of rapid disenrollment
  • Establish and maintain on - going relationships with the key physicians, hospitals, long - term care facilities, and other pertinent providers
  • Develop and maintain strong relationships within the community including providers, business partners and community alliances, etc.
  • Active client / customer relationship management including the development and implementation of strategic partnership growth initiatives
  • Promote a positive image of United with local providers, state regulators and customers
  • Ensure Regulatory compliance


Required Qualifications:

  • 3+ years of experience in a Medicare / Medicaid industry (Operations, Revenue, Membership growth, Contracting etc.), at - risk managed care environment
  • 3+ years leadership and management experience in an organization that serves the population of individuals who qualify for both Medicare and Medicaid
  • Strong financial acumen and analytical skills
  • Experience in strategic planning and development
  • Demonstrated successful leadership skills in program execution and people management
  • Proven leadership skills in both internal and external environments
  • Ability to execute to short and long term growth and profitability targets
  • Strong negotiation skills, budget management experience and regulatory knowledge
  • Leadership and management experience in effective team building and continuous quality improvement programs
  • Working knowledge and experience in cross - functional business segments and their integrated influences and relationships
  • Effective and experienced in motivating and mentoring others who are not in a direct reporting relationships

Preferred Qualifications:

  • Master's Degree preferred in business, nursing, health sciences, or social services administration
  • Previous P&L management experience

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)


*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.



Diversity creates a healthier atmosphere: 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.



Job Keywords: Product Manager, Health Benefits, Medicare, Medicaid, state of Virginia, operations management, Richmond, VA, Virginia, Telecommute

Job Details

  • Contest Number743908
  • Job TitleDirector Member Operations - Medicare DSNP - VA Telecommute
  • Job FamilyProduct
  • Business SegmentCommunity and State

Job Location Information

  • Richmond, VA
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelDirector
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionYes
  • Overtime StatusExempt

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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