AMVETS Jobs

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

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

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.

Responsibilities: Manage provider incentive programs. The role involves working with STARs and HEDIS performance metrics to ensure provider networks engage in competence and practice screenings, as well as care management to meet quality standards. Providers are incentivized to implement workflow changes to achieve these goals. Develop programs that offer bonus dollars, similar to how CMS awards STAR ratings to health plans, but at the provider level. Responsibilities: Knowledge of HEDIS and STARs Performance: Understand and translate these metrics into effective incentive Programs Management: Drive all aspects of managing incentives, including creating reporting tools, presenting updates, tracking effectiveness, and monitoring financials. Return on Investment: Ensure investments in these programs yield positive returns.

Required Qualifications:

• 15+ years of management-level experience in managed care, medical management programs required, including five or more years of experience at the Director level or above

• Demonstrate knowledge of the business environment and business requirements (e.g., strategy changes, emerging business needs)

• Knowledge of federal and state laws and NCQA regulations relating to managed care, and all aspects of Medical Management

• Knowledge of fiscal management and human resource management techniques

• Proven ability to establish and maintain effective working relationships with employees, managers, healthcare professionals, physicians and other members of senior administration and the general public

• Proven excellent verbal, written communication, presentation, and facilitation skills

• Ability and willingness to travel as determined by business need

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

The salary range for this role is $124,500 to $239,400 annually based on full-time employment. 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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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