Director, ASO Program Operations - Remote in Colorado

About the position

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 to start Caring. Connecting. Growing together. The Director ASO Program Operations is contractually required per the ASO SOW as listed in Exhibit A, section 3C, and shall serve as RMHP's primary point of contact for NHP. Supports corporate objectives by developing, maintaining and utilizing expert knowledge of Government Programs, including operations as a Medicaid Regional Accountable Entity (RAE). Provides expertise, leadership, and oversight to support NHP operations for ACC3.0 Medicaid state program activities and initiatives, including health plan operations that affect customer service, enrollment, IT, reporting, provider contracting, provider relations, vendor contracting, performance guarantees, and clinical operations. Prepares RMHP operations for RAE Region 2 growing government programs membership. Provides project management support for new and expansion activities. Lead and participate in JOS team meetings with Executive Leadership of NHP as well as RMHP. Develops and prepares monthly status reports of all contractually required ASO services. Accountable for meeting Medicaid ACC3.0 performance guarantees as well as ASO contractual performance guarantees.

Responsibilities

• Works collaboratively with the Chief Operating officer and all health plan Executive leadership to assist in maintaining and enhancing RMHP's reputation as the leader in Medicaid managed health care.
• Provides leadership by example to embed the organizational philosophy and culture.
• Directly accountable for managing day to day operations of the ASO contract and direct oversight of the company's Medicaid RAE Region 2 ASO agreement.
• Directs, plans, communicates, anticipates, facilitates, and manages the implementation of new requirements for Medicaid RAE Region 2.
• Communicates internally all changes and new requirements for ASO expansion activities.
• Provides project management and support for new and expansion activities.
• Anticipates potential contractual misses through thought leadership and observation of health plan and enterprise performance.
• Provides education to RMHP, COPA, and enterprise operations staff regarding ASO SOW changes.
• Develops and maintains effective interactions with all levels of the RMHP and NHP operations and Executive Leadership teams.
• Effectively manages and balances a variety of projects and competing priorities.
• Works with Community Integration Director to strategically plan for Medicaid RAE ACC3.0.
• Provides thought leadership for new initiatives and major projects for enhancements.
• Identifies opportunities for growth, sustainability, affordability, and efficiency in Medicaid RAE Region 2.
• Maintains stakeholder intelligence and assists with the organization, writing and submission of RFP and grant opportunities.
• Supports joint quality and payment incentive projects agreed by RMHP, NHP, and HCPF.
• Coordinates the production of actuarial and financial modeling, analysis and presentation materials.
• Develops, oversees, and ensures that filings, reports and billings for Medicaid RAE Region 2 are made accurately and on a timely basis.
• Monitors and ensures responsiveness and compliance with government contracts, directives and laws.
• Provides thought leadership and oversight to quality improvement initiatives for the RAE.
• Manage staff members who also support the ASO RAE Region 2 contract.
• Select, train, develop, appraise, and motivate qualified staff.
• Work proactively with other departments to ensure processes and staff are aligned.
• Provide effective communication within the department and with other internal and external departments.

Requirements

• Bachelor's degree in health care policy, business, public health, or a combination of education and experience.
• Experience with and knowledge of principles of local, state, and federal government operations.
• Demonstrated ability to communicate effectively at all levels with an organization.
• Driver's License and access to reliable transportation.

Nice-to-haves

• 5+ years of progressive experience designing and providing training in health care management, project management, regulatory compliance and advanced knowledge of health care and health coverage issues and regulations.

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase.
• 401k contribution.