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Director of ASO Affordibility - Virtual

UnitedHealth Group

Los Angeles, CA
Job Code:
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Job Details

Director of ASO Affordibility - Virtual(Job Number:728928)

Director of ASO Affordability

The position will have responsibility for development and execution of cross-functional strategies, projects and tactics which result in incremental, measurable medical/pharmacy cost savings for National ASO accounts. Savings will be achieved through a variety of methods, including leveraging and collaborating with Product, Clinical, Network, Data Analytics, Sales and other enterprise resources to maximize savings. Strategies will be aimed at achieving measureable incremental value over the previous year.

The role will also have responsibility for assisting in program management and implementation of cross organizational initiatives such as ER, Catastrophic Case Management, Opioid Management and Specialty Medications.

Job Components:
• Develops, translates and executes strategies or functional/operational objectives for Virtual Health Plan accounts along with ASO National accounts, with focus on Trend guarantee customers.
• Directs and leads interactions with partner teams such as benefits, Network, Sales to resolve highly complex or unusual business problems that affect major functions or disciplines.
• Accountable for ensuring seamless implementation of initiatives that will impact medical trend management for ASO National Accounts.
• Investigate new opportunities for affordability tactics by reviewing data/current FI initiatives and research for potential consideration for ASO clients. Present and champion recommendations to Account Management and directly to VHP and ASP clients.
• Review and interpret employer group expectations and populations in order to determine the potential impact to employer plan membership
• Analyze and consult on benefit Cost Ratio; prevalence rates; Unit Cost Reduction Trend in order to determine which programs to implement and/or modify (determine pmpm savings for clients and pmpm cost of implementation if applicable)
• Ownership of key ASO Affordability projects. Utilize standard project plan templates incorporating Enterprise wide affordability tools and road maps modifying to meet ASO requirements. Responsible for all status updates and reporting associated with these projects.
• Review, create, and/or maintain workflows as part of the account management and or projects, as required.
• Assist internal and/or external business partners with completion of tasks and resolution of issues and problems with program implementation
• Leverage clinical acumen and/or claims and coding expertise to provide guidance to staff (e.g., disease state, health conditions)
• Identify resources (e.g., funding; staffing, etc) required to implement programs.
• Work in partnership with Clinical Leadership to dfd
• -Review, create, and/or maintain workflows as part of the account management and or projects
• -Research competitor and external information regarding key network characteristics and
• contracting strategies in order to develop products and programs
• -Provide input to internal stakeholders (e.g., growth team) in order to drive effective medical cost management/trend management
• -Assist with RFP/contract language as indicated for project

Decision making authority
• Provides leadership to, and is accountable for, the performance and results of trend mitigation through multiple layers of management and senior level professional staff (e.g. Develops affordability initiatives that will impact the trend of our ASO clients to mitigate the $60 million in payout from CTGs. These AS) clients contribute approx. $200 mil in revenue)
• Empowered to develop, fund, and implement initiatives up to $100k without additional approval; expected to manage approval process for initiatives exceeding that amount with appropriate executive stakeholders.
• Drives implementation of affordability initiatives for National Accounts
• Serves in a leadership capacity to manage (dotted-line) cross organizational operational teams of 3 - 4 management level employees, responsible for the delivery initiatives to mitigate medical trend issues.
• Responsible for coordination of data requirements and strategic direction for National Account Affordability Initiatives.
• Participates in, and takes a co-leadership role, with certain aspects related to creating, launching, and/or implementing new Enterprise-wide cost saving initiatives which can consist of Network, Claims Operations, Products and lines of service.

Job Clinical Practice Consulting
Primary Location US-CA-Los Angeles
Other Location US-NY-New York, US-FL-Tampa, US-TX-Houston, US-AZ-Phoenix, US-IL-Chicago
Organization E&I Clinical Solutions
Schedule Full-time
Number of Openings 1
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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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