Project Manager / Affordability Manager - Community & State - Full-time / Part-time

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)
 
Primary responsibility of this role is to develop and implement medical cost containment strategies, tactics, and/or programs for C&S health plan(s), in conjunction with the local health plan leadership, regulatory leads, and subject matter experts (including operational leads specific to C&S).  The role also includes management of special projects that directly impact the medical costs for the health plan with additional accountability to ensure alignment across all lines of business when applicable.  Primary Responsibilities:

Responsible for leading the identification and evaluation of MCI initiatives, in coordination with the local health plan and Healthcare Economics (HCE).  Coordinate the review of market level medical cost data for opportunities to mitigate trends and the review of opportunities deployed in other markets / segments, i.e. leverage best practice-sharing opportunities through collaboration and interfacing with other regions / markets and plan.  Work with C&S HCE and local health plan leadership to complete cost benefit analyses on proposed initiatives
Deploy identified MCI initiatives, ensuring that the “road to deployment” is followed and presenting to Medical Cost Management Team (MCM) and other oversight committees when applicable
Serve as liaison between National Line of Service teams and National Programs and local health plan to ensure market level needs are being incorporated into strategy development and implementation plans
Responsible for interfacing with health plan regulatory leads related to assigned projects to ensure that projects meet state / federal guidelines and that the requirements are clearly documented and communicated to the project team
In conjunction with health plan leadership, may present projects with supporting data to regulators and Departments of Insurance / Health as needed.  Assists the C&S health plans in responding to inquiries from regulators and Department of Insurance on issues pertaining to affordability projects
Work directly with the local health plan to understand and anticipate internal and external customer needs
Communicate to leadership the obstacles that may be hindering deployment and look for guidance / leadership on removing those obstacles
Update the local health plan on MCI results and report on project status
Collaborate, motivate, and inspire other project team members that are assigned to project teams

Required Qualifications:

Undergraduate degree or equivalent combination of education and experience
5+ years of experience working within a managed care organization
3+ years of experience with network provider projects
3+ years project management experience
3+ years working with data analytics and financial analysis
2+ years of experience with provider network reimbursement methodologies
Excellent verbal and written communication skills
Problem solving skills, including the ability to systematically analyze complex problems, draw relevant conclusions, and successfully devise/implement solutions calmly and effectively
Ability to multi-task, shifting back and forth effectively among multiple activities
Proficiency in Microsoft Excel, Word, PowerPoint
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)
 
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.
  
 
Job Keywords: community & state, affordability, manager, managed care, provider network, analytics, telecommute, Minnetonka, MN, Minnesota, Hartford, CT, Connecticut, Maitland, Tampa, Orlando, Miami, FL, Florida