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Sr. Director, Bundled, Payment Program Management - Telecommute

UnitedHealth Group

Centennial, CO
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Job Details

758342 Sr Director Bundled Payment Program Management Telecommute

Sr. Director, Bundled, Payment Program Management - Telecommute (758342)

Position Description

You've been working your way to this opportunity for some time now. You've learned to lead. You've build a deep expertise in health care network operations. You've set your sights on having more impact in more ways. It's time to join our leadership team and help UnitedHealth Group meet the challenge of shaping where health care will go. We're driving ever higher levels of sophistication in how provider networks are composed and compensated. Your expertise in provider networks can help us build in the next phase of evolution. In this Director level role, you'll use your knowledge and analytical skills to help determine how clinical providers group up by specialty and service line. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 6 leader.


Primary Responsibilities:

  • Develops and executes strategies for the Bundled Payment Team, part of UnitedHealth Networks Payment Strategy & Innovation Team
  • Directs and manages Regional Directors to resolve business problems that affect the deployment, successful implantation, and success metrics of our bundled payment programs
  • Primary responsibility is to own and manage the deployment of bundled payment programs, develop and evolve our Internal and external training materials and educational resources, manage the program PMO structure, and ensure internal alignment to optimize program deployment & performance
Functional Competencies
Build & Manage Relationships with Bundled Payment Program Stakeholders
  • Ensure successful recruiting, hiring and onboarding of new Bundled Payment staff
  • Serve as internal liaison to Sales, Healthcare Economics, Product, Clinical Services and other internal stakeholders to support and promote our Bundled Payment programs
  • Seek feedback from relevant internal and/or external stakeholders regarding potential bundled payment program improvement opportunities and needs
  • Develop tools and resources to ensure a consistent, clear message to our external stakeholders to demonstrate the value of our bundled payment programs
  • Collaborate with relevant internal and/or external stakeholders to resolve issues and obstacles with network/program/contract performance
  • Collaborate with the Regional Presidents and Regional Strategy Leads to ensure Bundled Payment value propositions are widely understood and leveraged
  • Develop and promote program performance metrics to all applicable stakeholders to provide performance updates regarding bundled payment agreements including goals; timelines; schedules; issues; performance against standard contract agreements)
  • Follow-up with internal stakeholders to ensure issues have been resolved and addressed effectively and timely
Leverage Network and Provider Performance Data
  • Gather data from relevant sources in order to respond to stakeholders' requests (e.g., Sales and purchasing group presentations, provider requests for Bundled Payment data, etc.)
  • Ensure provider reporting for Bundled Payment programs is actionable and meets the needs of providers looking to transform care delivery to promote the triple aim
  • Analyze provider performance along key indicators including financial performance, quality metrics, market benchmark data, and ACO utilization in order to optimize the value of Bundled Payment Programs
  • Research competitor and external information regarding key network characteristics and contracting strategies in order to evolve our Bundled Payment programs
Develop, Launch, and Evolve Effective Bundled Payment Programs
  • Provide guidance to internal stakeholders regarding administration of bundled payment contracts, including our Optum partners
  • Track and report on Bundled Payment volumes to ensure proper accounting and accruals for inter-segment agreements with Optum and Finance
  • Identify needs and create contract language parameters for our bundled payment programs
  • Provide input and feedback to senior leadership in order to suggest/recommend improvements to our bundled payment programs, including changes and enhancements to our episode definitions and new episode categories for consideration
  • Create and implement internal and external training materials for our Bundled Payment programs including talking points; FAQs; timelines; and pitch decks in order to educate internal and external stakeholders on our programs and value proposition
  • Ensure consistency with outreach and communication efforts between Regional Directors of Bundled Payment and the local markets/providers
Demonstrate Knowledge of Program Management Tools, Regulations, and Systems
  • Demonstrate understanding of demographic systems (e.g., Emptoris; NDB)
  • Demonstrate understanding of claims platforms (e.g., Galaxy; COSMOS; NICE; FACETS; Diamond; PPO-One)
  • Demonstrate understanding of report generation and workflow management systems (e.g., ChartFinder; InSite; Sharepoint Documentation; Salesforce)
  • Demonstrate understanding of contracting strategies (e.g., facility; ancillary; physician) in order to support field objectives/MBOs
  • Demonstrate understanding of key provider/contract/network performance and/or risk adjustment indicators (e.g., prevalence rate; recapture rates; MWOV; RAF scores)
  • Demonstrate understanding of provider group operations and stakeholder/client business models
  • Demonstrate understanding of documentation and coding procedures (e.g., ICD-9)
  • Demonstrate understanding of applicable health care regulations (e.g., HIPAA; ARRA; CMS)
  • Demonstrate understanding of operations of key business partners (e.g., Clinical Service; Medical Management; Health Care

Required Qualifications:

  • 10 years’ experience working with a managed care organization or health insurer; or as a consultant in a network/contract management role

  • 7 years of data analysis experience
  • 5+ years’ experience managing staff

  • 3+ years’ experience with contract submission, validation and maintenance with strong knowledge of business processes that impact facility/ancillary contact loading and auditing

  • 5+ years’ experience with or understanding of claims systems/processing

Preferred Qualifications:
  • Bachelor’s degree
  • Project Management or program management experience
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)


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 Details

  • Contest Number758342
  • Job TitleSr. Director, Bundled, Payment Program Management - Telecommute
  • Job FamilyNetwork Management
  • Business SegmentUnitedHealthcare Networks

Job Location Information

  • Centennial, CO
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelDirector
  • ShiftDay Job
  • TravelYes, 25 % 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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