Director of Operations - Community and State - Miramar, FL

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm) This C&S plan leader has accountability for several operational areas and will report directly to the C&S COO in the planning and execution of strategies within the Statewide Medicaid Managed Care (SMMC) program in Florida. This role will be accountable for operational functions within several areas such as enrollment, member materials, ops reporting, social media content, and analytics. This position will require a strong collaborative perspective and related professional network from which to garner support for daily projects and strategic initiatives. It is expected that the Director, Operations will contribute to ongoing enterprise and region wide discussions on business growth and development, focus on continuous quality improvement, and mange through consistent application of data-informed decision making. This leader's primary responsibilities are directed towards C&S plan activities as defined by the C&S plan COO and will also collaborate often with leaders in the Long Term Care program (part of the SMMC program) as well as other market and regional matrix partners to implement programs to support and meet market C&S line of business goals.Primary Responsibilities:

Assist internal and/or external business partners with completion of tasks and resolution of issues and problems with program implementation
Analyze operational performance on relevant criteria (e.g., targeted financial metrics; quality indicators; performance guarantees
Partner with relevant internal and / or external stakeholders to develop and/or review potential operational strategies, programs, and plans (e.g., affordability initiatives; quality programs; projected resource needs)
Ensure performance is tracked accurately utilizing internal tools and processes (e.g., dashboards; scorecards; reports) in order to facilitate performance review and analysis
Conduct deep dive program reviews with relevant internal and/or external stakeholders to identify opportunities for continuous improvement
Review, create, and / or maintain workflows to ensure they are up-to-date and operationally efficient
Provide guidance, expertise, and / or assistance to internal and / or external partners (e.g., claims; call center; benefits; clinical) to ensure programs and strategies are implemented and maintained effectively
Utilize stakeholder input to help shape and implement continuous improvement in operational quality and financial performance (e.g., encourage participation in Six Sigma projects)
Monitor project performance against internal and / or external service level agreements
Incorporate operations program performance information into strategic and business planning and / or incentives
Conduct regular meetings (e.g., JOCs; QBRs) with relevant internal and/or external stakeholders to review and discuss updates and outstanding issues (e.g., project implementation readiness; compliance and/or quality audit results; out-of-compliance issues; staffing issues)
Ensure relevant internal and/or external stakeholders (e.g., vendors; providers; leased network) are provided with correct and/or updated processes, programs, and / or policies (e.g., fee schedules)

Required Qualifications: 

Bachelor’s degree
3+ years’ experience in operations or program/project management
Intermediate level of proficiency in MS PowerPoint, Word, and Excel
5+ years of prior experience driving and executing in a cross-functional organization
3+ years of experience in Market health plans and health systems and provider populations
3+ years of experience managing others
Preferred Qualifications: 

Broad knowledge of UnitedHealth Group operational systems and processes (Provider Data, Claims, Finance, etc.)
Expertise in a well-established business operations and / or quality improvement methodology (e.g., Business Process Management, Six Sigma, or Total Quality Management)
Proven ability to influence course of action when others are directly accountable for outcome
Demonstrated ability to communicate complex ideas clearly and concisely and the ability to facilitate meetings
Ability to understand the underlying business model and question / challenge others to think through the problems, improvement opportunities, solutions, and plans
Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to 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:  C&S Plan Leader, Miramar, FL, Florida