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Sr Director Advisory Services - Health Plan Operations (Payer & Provider)

UnitedHealth Group

Eden Prairie, MN
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Job Details

741235 Sr Director Advisory Services Health Plan Operations Payer Provider

Sr Director Advisory Services - Health Plan Operations (Payer & Provider) (741235)

Position Description

No industry is moving faster than health care. And no organization is better positioned to lead health care forward.  We need attention to every detail with an eye for the points no one has considered. The rewards for performance are significant. You'll help improve the health of millions. And you'll do your life's best work.(sm)


The Senior Director Health Plan Operations is a senior leader within the Optum Advisory Service - Business Performance practice serving health care provider and payer clients. The role requires a senior consulting leader with proven experience developing business strategies with clients.  The role includes identifying and leading the creation of new Advisory Service offerings as well as delivering consulting engagements in the provider and payer markets.


The leader in this role will partner closely with the business development teams to drive the necessary market demand to achieve financial objectives. He/she will also be responsible as a subject matter expert within Provider and Payer Operation to help expand existing accounts and help drive new business striving for strong client delivery and satisfaction for Optum.


Success in this role requires large scale consulting experience with both strategic and operational business domain experience within Provider and Payer Operations including eligibility, benefits, product design, claims, operational financial management, medical management (utilization, disease, care management), etc. coupled with prior experience identifying and developing new Advisory service offerings to take to market.


You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.


**Travel is required for this role and typically our associates travel Monday through Thursday. Location of residence is flexible for this role; however, travel is a requirement.**


Primary Responsibilities:

  • Market Planning and Thought Leadership (10% Time Allocation):

    • Define market needs & gaps to current capabilities (matrix with Marketing and Sales teams)
    • Research and formulate solutions to address fluctuating market conditions
    • Drive market acceptance, competitive advantage & customer satisfaction of Optum Solutions, Products and Services
    • Define Points of View for best practices and develop key performance indicators to show value
    • Work with government relations to understand regulatory opportunities/risks and align government relations with long-term marketing and delivery plan
    • Identify and develop consulting offerings, products, services solutions that align with key market needs and or client initiatives
    • Determine pricing models and options for new solutions
  • Sales Support (50% Time Allocation):

    • Develop proposals and statements of work for client specific engagements
    • Participate, support and complete RFI, RFP and sales process
    • Complete financial analysis for proposed solutions
    • Builds Marketing and Sales Collateral
    • Attends and participates in oral presentation
  • Client Management and Client Satisfaction (10% Time Allocation):

    • Establish trusted partner relationships to expand Optum’s footprint at designated clients
    • Work with client to lay out strategic roadmap for consulting solutions
    • Provide financial and data analysis to support ROI for project funding
    • Obtains high client satisfaction scores (>90%)
    • Develop and maintain clients reference
  • Program Oversight & Service Delivery (30% Time Allocation):

    • Direct responsibility for the oversight, hands on participation and delivery of large scale projects/programs. Large scale programs are defined as high cost, high complexity and/or high risk
    • Ensure utilization rate and billable revenues are attained annually
    • Facilitate development of business segment and enterprise level planning and program objective setting
    • Participate in senior level program funding and prioritization decision processes
    • Provide strategic input to the development of program roadmap and timelines
    • Create a team oriented work climate that enables professional development and encourages creative solutions and
    • strategies
    • Support the management of resources within programs
    • Support program communication plan and execution
    • Require that quality assurance methods are implemented within the program
    • Provide status updates and review of programs to senior leadership
    • Provide coaching and mentoring of project team with the goal of developing and retaining talent within the organization

Required Qualifications:

  • Experience running a Payer Operation for a Health Plan and/or Run Healthcare Practice or Operation Practice for a Management Consulting Firm
  • Proven success leading the identification, creation and implementation for new go to market service offerings
  • 10+ years of extensive Payer Operations experience within a consulting or payer related organization
  • 10+ of Operation Process Improvement, Root Cause Analysis experience
  • Proven experience in data analysis and financial analysis to help demonstrate ROI, support client in the creation of their business plan, and obtain necessary capital/project funding
  • Ability to think strategically, proven experience laying out strategy, developing products and/or services from ground up that would be sold in the commercial market
  • Proven problem solving skills (identification of issue, causes, solution, implementation plan)
  • Project management - strong project tracking, presentation and reporting skills
  • Understand claims impact on reserves
  • Strong ability to influence and motivate
  • Experience writing and executing business plans for new consulting solutions
  • Ability to travel up to 80% **See note

Preferred Qualifications:

  • Bachelor's Degree
  • Master's Degree in computer or business related field
  • 5+ years working in a Big 5 or other large consulting organizations
  • Demonstrated experience with proven process improvement methodologies (Six Sigma, TQM, etc.)
  • Familiarity with audit stratification and methodology

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity 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: 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.



Job Keywords: Director, payer, consulting, consultant, health, healthcare, operations, health plan, management Consulting, process improvement, telecommute, travel, Eden Prairie, MN, Minnesota, Optum Advisory Servces, OptumConsulting

Job Details

  • Contest Number741235
  • Job TitleSr Director Advisory Services - Health Plan Operations (Payer & Provider)
  • Job FamilyOptumInsight Consulting
  • Business SegmentOptumInsight

Job Location Information

  • Eden Prairie, MN
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelDirector
  • ShiftDay Job
  • TravelYes, 75 % of the Time
  • 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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