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The Sr. Director – Business Operations and Program Management Optum West is responsible for supporting the medical management teams in strategy development and execution of critical operational and strategic initiatives enhancing quality of care, impacting total cost of care, and legal, regulatory, and compliance for all markets in the west region. The Sr. Director plays a critical leadership role in accelerating the operational integration and transformation of key high-value regional functional workstreams. The role develops and operationalizes key programs, provides end-to-end project management for large and complex initiatives, leads change management and transformation activities to ensure adoption and sustainability. The role encompasses development and proliferation of best practices, industry standards, templates, and tools to enrich learning, development, and execution across the department. The role collaborates closely with senior leaders within medical management and across all supporting functions to support continuous process optimization and standardization and provides support and leadership in the integration of all Optum West markets. The role is a critical part of the Optum West leadership team and works directly with local, regional, and national leaders, including but not limited to operations, physician leadership, medical directors, compliance, regulatory, legal, systems, network, contracting, finance, pharmacy, delegation, and claims.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Must work PST hours.

Primary Responsibilities:

• Provide program management, leadership, and support across all medical management services (PreService Review, Inpatient UM, Care Management, Delegation Oversight and QI, and Business Operations)

• Partner with leaders to develop, refine, and flawlessly execute strategic initiatives that support the organization’s goals and objectives for cost efficiency and quality improvement. Accountable for process improvements, adoption management, change management, and transformation

• Provide end-to-end project management from strategy through implementation for large and complex operational and systems initiatives leveraging proven project management methodologies, industry standards, best practices, tools, and templates

• Leads strategy, planning, governance, systems, and operational meetings with all levels of executives, cross-functional leaders, and front-line staff

• Establish metrics and KPIs to track the effectiveness of programs, regularly report on current state aligned with targets, trending, and make data-driven recommendations for improvements

• Identify process standardization and optimization opportunities, lead the design through implementation, track and monitor outcomes, and drive continuous improvement

• Develop and apply decision frameworks to reach discrete outcomes for complex programs; lead strategy development, operational and systems planning through implementation and operations management

• Ensure all programs, processes, technology solutions, and deliverables (e.g., letters, reports) are compliant (e.g., state, federal, health plan, DMHC, NCQA, URAC), and proactively manage changes, impacts, and risks

• Define data needs, facilitate data pull(s) and analysis, define insights, create presentations, walkthrough results of the data analysis, and influence and drive data driven recommendations and decisions

• Provide guidance, leadership, and management for program and project teams, foster a collaborative environment, and build high-performing teams with a keen focus on quality and flawless execution

• Set direction, rapidly resolve issues, breakdown barriers, and mentor cross functional resources

• Foster a culture that encompasses our core values of integrity, compassion, inclusion, relationships, innovation, and performance

• Coordinate and facilitate engagement of cross-functional stakeholders (e.g., business, operations, claims, systems, finance, accounting, compliance, legal, regulatory, people business partner)

• Manage and lead business operations, multiple programs and projects simultaneously, prioritize work efforts, and effectively communicate with executives and all level of the organization

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 5+ years of program management and project management, leading large and complex technology and operational projects end-to-end. 5+ years of end-to-end medical management platform implementations (e.g., functionality, automation, letters, reporting, templates, etc.), inbound and outbound data feeds, upstream data mapping into the medical management platform and downstream data mapping (e.g., into claims platform), data retention/retrieval/archival/storage, and sunsetting systems

• 5+ years working with all lines of business, such as Medicare/Medicare Advantage, Medicaid, Commercial, and Dual Eligible

• 5+ years of experience with model of care requirements, managed/value-based care, and medical management responsibilities, such as UM, CM, Delegation Oversight, risk-based contracts, and value-based contracts

• 3+ years directly leading and managing teams

• Knowledge of federal and state laws and NCQA regulations relating to managed care, disease management, utilization management, discharge planning, and complex care management and case management

• Solid healthcare technology and business acumen

• Advanced skills with the Microsoft Suite (e.g., Excel, PowerPoint, Word, Outlook)

• Advanced data, data analytics, data-driven decision making, and reporting

Preferred Qualification:

• PMP certification through PMI

Professional Competencies:

• Solid operational mindset, ability to use data to draw insights, and data-driven decision making

• Solid ability to communicate in written and verbal presentations

• Solid relationship development and team management skills

• Success in driving process optimization, transformation, organizational change, adoption management, and performance improvement

• Solid collaboration skills to ensure effective alignment among diverse teams

• Ability to excel in a matrixed environment

Travel:

• 25% travel within the Optum West Region

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $122,100 to $234,700 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: OptumCare 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.