Retiree Solutions Market Manager - North Carolina - Full-time / Part-time

Are you ready for your next challenge? Discover it here at UnitedHealthcare and help us reinvent the health system. This can be your opportunity to take on a role that helps us offer a higher level of care than you'll find anywhere else.  Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.

The United Retiree Solutions (URS) Clinical Team is responsible for ensuring our Medicare Advantage members receive the right care, at the right time, at the appropriate cost. This position will be located in a key strategic state for URS and will work closely with Market Teams, Client Management Teams, and Employer Groups to research, develop and present new or existing strategies to improve STAR performance, reduce inappropriate medical costs, and ensure accurate documentation of member's conditions. We support the largest Medicare Advantage plan in UnitedHealthcare.

Primary Responsibilities:

• Utilize data analysis, identify areas of improvement opportunity for Star measures, medical cost reduction, and Risk Adjustment Factor (RAF) scores


• Partner with market teams (Optum Market Consultants, UnitedHealth Network, and Medicare and Retirement) to create and implement improvement plans


• Educate and partner with market teams on specific needs for URS business priorities


• For assigned Employer Group Accounts, be the liaison to the assigned Client Management Team for Star, RAF, and medical cost reduction opportunities


• Participate in market meetings to represent URS needs and look for opportunities to leverage or expand local Medicare efforts


• Create monthly report highlighting Employer Group Account specific performance and recommendations for partnership opportunities


• Develop strong working relationships with the United Retiree Solutions Client Management Team, M&R RVP's, UHN Market Leaders, and Optum Market Consultants


• Negotiate priority of key initiatives and strategies with senior business leaders for the assigned states and employer groups


• Be the primary go to person for all STARS related activities within their assigned employer groups working within a matrix relationship which includes United Healthcare's Regional Vice President, Group Retiree Stars Program Team, Health Plan Medical Directors, Marketing/Communications, UHN, URS Client and Optum and other team members to assure that all STARS activities are planned and executed

Required Qualifications:

• Undergraduate Degree


• 3+ years collecting, synthesizing and interpreting complex data, and making strategic recommendations regarding opportunities and challenges for business improvement


• Strong executive communication and presentation skills


• 3+ years business experience with health care industry


• 3+ years project management experience


• Strong knowledge of Star Ratings or demonstrated experience in learning complex quality initiatives.


• Proven record in driving substantial quantifiable operational improvements


• Microsoft Office:  Excel, Outlook, PowerPoint and MS Access skills


• Willing to travel 25% primarily in state of North Carolina,  with possible minimal travel to other states

Preferred Qualifications:

• RAF experience


• STARS experience


• Medicare experience


• Medical/clinical background desirable


• Client or account management experience

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)

Diversity creates a healthier atmosphere: 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: humana, aetna, medicare, STAR, risk adjustment factors, (RAF), project manager, retirees, managed care, health insurance, account manager