Sr. Director, Medicare Advantage Product or Benefits
taleoEden Prairie, MN
$159,300 per year
Apply nowSr. Director, Medicare Advantage Product or Benefits
L7
taleoEden Prairie, MNtoday
$159,300 per year
Industries
Direct Health and Medical Insurance CarriersDirect Life Insurance CarriersPharmacy Benefit Management and Other Third Party Administration of Insurance and Pension FundsImprove the lives of others while Caring. Connecting. Growing together.
Job Description:
Sr. Director, Medicare Advantage Product or Benefits (2385393)
Sr. Director, Medicare Advantage Product or Benefits - 2385393
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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
Position Summary:
The Optum Health Enterprise Payer Team is responsible for owning, driving, and optimizing Optum Health’s payer portfolio to achieve sustainable value-based care relationships. The Senior Product and Benefits Director will play a critical role in developing strategies to successfully position Medicare Advantage products within Optum Health value-based care arrangements including benefit design and planning, sales distribution relationships, identifying best practices, and AEP/OEP/SEP payer performance.
This individual will be expected to:
Be the subject matter expert for Medicare Advantage benefits and products including product management, product definition, risk identification, standard benefit models, and financial and regulatory impacts
Own the Optum Health strategic analysis of Medicare Advantage benefit design and planning
Provide quantitative and qualitative interpretation of AEP payer performance to help advance Optum Health goals
Understand CMS required deadlines and quality requirements for Medicare Advantage products and programs
Understand the scope and strategy for bid submission, including defining standard benefit models and alignment to product strategy
Foster relationships with cross-functional partners to solve critical business initiatives
Proactively identify problems and develop recommended solutions
This individual will need to be able to function in a diverse environment with varying level stakeholders across internal and external stakeholder groups, abstract and fluid environments, and simultaneous deadlines. The position requires an ability to comprehend Medicare Advantage, local markets’ strategies while demonstrating awareness of broader systems across the enterprise, both strategically and tactically. Organizational agility will be required – building meaningful relationships and facilitating decision-making to continue achieving Optum Health’s value-based care agenda.
Primary Responsibilities:
Lead end to end benefit strategy for all payers across Medicare Advantage plans
Create solid relationships with payer product teams to align membership strategies with enterprise financial performance targets
Analyze benefit performance/ROI and develop investment recommendations
Partner with Health Care Economics and Actuarial teams to ensure MACVAT data is completed and correct prior to socialization with key regional partners
Conduct in-depth analysis and strategic summary of AEP results
Identify key benefit battleground states and areas of greatest risk and opportunity along with key market insights
Ensure cross functional collaboration with finance and HCE to quantify benefit decision impact
Partner with local growth and marketing teams on broker/partnership strategy and execution, to unify capabilities where possible and create a cohesive approach
Develop and socialize specific AEP strategies with leadership and provide market feedback
Develop executive materials for overall benefit strategies and approach
Collaborate with care delivery and Optum at Home to build risk programs that strengthen overall market positioning and advance Optum’s value prop to further differentiate for consumers and partners
Synthesize market, competitor, regulatory, financial, and operational intelligence to inform priorities, decisions, and future innovation opportunities
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
10+ years of experience in healthcare strategy, Medicare, product management, innovation, or consulting
5+ years of health plan or Medicare Advantage experience
Expert knowledge of Medicare Advantage benefits and products including product management, product definition, risk identification, standard benefit models, and financial and regulatory impacts
Experience with Medicare Advantage bid filings
Demonstrated ability to achieve high performance by utilizing resources in a matrix environment
Demonstrated ability to work with and communicate with all levels of the organization
Proven solid analytical skills
Preferred Qualifications:
Knowledge of Medicare Stars, HEDIS, value-based care models, provider incentives, care gap closure, supplemental data exchange, pharmacy quality, affordability/utilization, and provider engagement operations
Experience working with Actuarial and Underwriting teams
Proven ability to achieve superior results in a performance-oriented environment
Proven ability to work with all levels of management across all functions and business partners
Demonstrated problem solving, analysis, and resolution at strategic and functional levels
Demonstrated ability to manage competing priorities and a rapidly changing business environment
Demonstrated excellent written and verbal communication skills
Willingness to travel up to 20%
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $159,300 - $273,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
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.
UnitedHealth Group is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or accommodation for any part of the application process, please call 1-866-566-8715 to be connected to Recruitment Services. Recruitment Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through Friday.
UnitedHealth Group is a registered service mark of UnitedHealth Group, Inc. The UnitedHealth Group name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the UnitedHealth Group, Inc.
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.
Apply now
Level
ManagerL7
Salary
$159,300 per year
Location
Eden Prairie, MN
Occupation
Compensation and Benefits Managers
Industry
Direct Health and Medical Insurance Carriers
Posted
today
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