Health Plan Operations Manager I - Ridgeland, Mississippi - Full-time / Part-time

In this Health Plan Performance Manager role, you will be responsible to drive solid understanding and adoption of the three components of our State Partner becoming a reference account and a promoter of UHC -- Operational Excellence, Collaborative Relationships and Thought Leadership/Innovation across the Health Plan, C&S Functional Teams and UHC Shared Services. This role reports to the Southeast Region Performance Excellence and Accountability Leader with matrix accountability to Health Plan President and operations leader.   

Primary Responsibilities:  

• Understand and educate C&S Functional Leaders and UHC Shared Services Partners (matrix partners) on State Contractual / Market / Member Benefit Requirements in partnership with Compliance to assure understanding and accountability


• Build strong relationships with our matrix partners (including Claims, Member/Provider Call, Provider Operations, Appeals & Grievances, Enrollment/Eligibility, Encounters, IT, Provider / Member Experience, Clinical, Quality) by fostering and leveraging an account team structure that is involved in key Health Plan strategic initiatives, goals and activities


• Ensure matrix partner processes meet State / Market requirements by assuring that we are working within UHG and State guardrails / requirements. When necessary, you will facilitate resolution of concerns with established guardrails / requirements trying to ensure a win for both UHG and the State


• Analyze metrics and trends to ensure contractual / market requirements are met, and working with matrix partners to improve performance when not met


• Drive performance excellence and accountability by developing relationships with and working across our matrix partners to eliminate identified barriers to creating new and maintaining existing reference accounts


• Be a trusted resource for the local Health Plan and assure that every State requirement, process, project and service has an owner within the matrix that will be most effective in execution


• Identify opportunities for innovation, productivity improvement and savings


• Perform special projects as assigned by Leader or Health Plan

• 2+ years demonstrated experience working in a highly matrixed environment


• 2+ years demonstrated experience managing and driving team performance


• 2+ years in-depth managed care health plan operations experience to include, but not limited to claims, member/provider call center, enrollment and/or eligibility, and provider operations


• 2+ years experience managing multiple projects/tasks to meet contractual deadlines or other time sensitive commitments


• MS Excel, MS Project, PowerPoint and Visio skills at an intermediate to advanced level


• Proven ability to influence course of action when others are directly accountable for outcomes


• Ability to manage multiple tasks and priorities in a matrix environment, strong problem solving skills and attention to detail


• Demonstrated experience to drive Performance Excellence and Accountability change level projects from the start to finish


• Demonstrated ability to interface and succinctly present to senior management effectively


• Demonstrated ability to anticipate and tie operational issues to financial outcomes in order to minimize unexpected hits to Health Plan's bottom line


• Excellent collaboration and drive for results and organizational excellence   

• Bachelor's degree


• Experience with SharePoint and/or Six Sigma


• Medicaid, CHIP, long term care and/or government health plan experience

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 14 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)