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VBR Implementation Mgr, C&S, DSNP or Medicaid - Remote

UnitedHealth Group
401(k)
United States, Minnetonka
May 29, 2023

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life's best work.(sm)

Join us to conduct, manage and drive projects and resources that result in successful implementation of a variety of Government Operations global risk capitation, PCP capitation or other value based arrangements, including claims and clinical delegation between UHC and OptumCare or other external entities. Develop your business knowledge of Medicare and Medicaid products, contracting practices, and Federal or State regulations while coordinating activities across more than 20 departments involved in a common purpose to serve our Community and State beneficiaries.

The selected candidate will become a subject matter expert in the area of operational tasks, sequencing and delivery of capitation, delegation and other risk based contracting. He or she will be viewed as a trusted partner for Government Operations teams, delivering with clarity, speed, quality and transparency.

You'll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:



  • Lead activities for assigned Delegation or Capitation initiatives for Community and State Facets which can include DSNP, Medicaid or IFP products
  • Ensure alignment and understanding of program/project scope and objectives with the organization's strategic objectives, in consultation with applicable stakeholders
  • Guide teams across multiple disciplines as they complete implementation tasks including provider setup, benefits, ID cards, claims, portals, member services, provider services, enrollment, encounters, mis-directed claims process, finance or other. Coordinate
  • with SMEs to address task sequencing and to help obtain information necessary to each team
  • Drive all components and deliverables throughout the project lifecycle
  • Contribute to project plans that define key tasks and milestones, taking feedback from SMEs and stakeholders. This includes suggested target dates and responsible team(s)/SME(s). Modify plans and customize as needed over time
  • Facilitate and manage mid to large size workgroups, enabling a culture of collaboration, trust and disciplined accomplishment of tasks and target dates
  • Probe at and document issues and set up calls outside the formal workgroup where needed to resolve open items; escalate critical issues quickly when needed
  • Assume ownership, over time, of one or more core team tools, applying project lifeycle experiences to improve our delivery and management of projects
  • Completes weekly status, monthly stakeholder and other applicable reports or dashboards
  • Establish, develop and maintain effective relationships with applicable project stakeholders including but not limited to project team members, delegated entity teams, internal customers, functional SMEs, business partners, leadership
  • Demonstrates ongoing ability to grow one's knowledge of end to end global risk, capitation and delegation from a process and systems function level, including knowledge of the business segment and related business teams involved in the scope of work
  • Acts as a resource for others; readily shares knowledge
  • Complete recommended and optional online coursework and orientation sessions to learn and deepen knowledge on capitation, delegation, risk based contracting, Government Operations and our platforms
  • Ensures operations is protected e.g. drives solutions that do not require significant adds to staffing, influences direction away from approaches and strategies that Operations cannot administer and ensure regulatory requirements are met
  • Drive process improvement activity where assigned, including definition of problem statements, metrics or data gathering if appropriate, facilitate work group dialogue, incorporation of lessons learned, identify participants, support ideation and solutions or tools needed


You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:



  • 3+ years of project management experience including prior experience in successfully managing one or more major projects which integrated multiple business areas or systems
  • 2+ years facilitating end to end mid to large size workgroups
  • 2+ years experience developing tools, task plans, milestone charts, status reports
  • Demonstrated experience with process improvement, workflow, benchmarking and / or evaluation of business processes
  • Demonstrate knowledge on Dual eligibility (Medicare/Medicaid) DSNP, Medicaid or IFP Plans and processes
  • Intermediate or greater level of proficiency with Excel, PowerPoint, Word


Preferred Qualifications:



  • Bachelor's degree in Business, Finance, Health Administration or related field
  • Advanced degree
  • 3+ years Facets experience or other Medical Claims System experience
  • Experience with Agile methodology


Soft Skills & Competencies:



  • Self directed, able to find answers/clarifications if not known
  • Ability to effectively interact with multiple teams in a fast paced environment
  • Ability to prioritize in an environment of rapid change
  • Takes accountability for decisions
  • Willingness to handle a variety of different types of project assignments when necessary vs. a fixed role/function
  • Excellent communication, time/project management, problem solving, organizational, and analytical skills required
  • Ability to build relationships
  • Ability to break through barriers that impede progress
  • Solid business partner focus
  • Self-starter; team player; quality minded; focused; committed; work independently
  • Able to stay committed to long-term project goals
  • Able to manage through diverse opinions and personalities
  • Capable of researching details if provided the tools and if provided the overviews of how to use them


Medicare and Retirement: Serving one in five Medicare beneficiaries, UnitedHealthcare Medicare & Retirement is the largest business dedicated to the health and wellbeing needs of seniors and other Medicare beneficiaries. For more than three decades, UnitedHealthcare has served the health care coverage needs of Medicare beneficiaries, navigating through multiple evolutions of the Medicare program and growing to become the preferred choice of more beneficiaries than any other company. Today we remain committed to providing people with a choice of innovative health and well-being solutions that help them access the quality care they need and enjoy the superior experience they deserve

UnitedHealthcare Community & State is dedicated to providing health care products and services to states that care for the economically disadvantaged, the medically underserved and those without the benefit of employer-funded health care coverage.

Careers with UnitedHealthcare. Work with a Fortune 5 organization that's serving millions of people as we transform health care with bold ideas. Bring your energy for driving change for the better. Help us improve health access and outcomes for everyone, as we work to advance health equity, connecting people with the care they need to feel their best. As an industry leader, our commitment to improving lives is second to none.

California, Colorado, Connecticut, Nevada, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New York, Rhode Island or Washington residents is $85,000 to $167,300. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

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.

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.

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