Executive Director - Multiple Locations, Pennsylvania Preferred

UnitedHealth Group•Pittsburgh, PA

1d•$159,300 - $273,200•Remote

About The Position

The Medicare & Retirement Executive Director has primary responsibility for defining, leading and driving local initiatives to achieve five Star CMS ratings, coding, growth, building Medicare networks, retention of Medicare members and affordability goals. The Executive Director sets strategy and prioritization with national shared service partners specific to the local market and ensures cross-organizational alignment. The executive director establishes and maintains clear leadership credibility and partnership with our external provider and broker partners. This role is responsible for identifying and leading new business strategies and initiatives to meet the needs of our members. Additionally, this role will address provider issues while working with multiple levels of staff across multiple functional areas across one or more business departments. These strategies will impact Medicare Advantage product development and planning, new business ventures, and market expansion.

Requirements

7+ years of healthcare or health plan experience
5+ years of experience working with hospitals and physicians
Demonstrated success building and managing relationships with external executives and stakeholders, including maintaining ongoing communication with CEOs, CMOs, and CFOs to drive performance and represent UHC
Demonstrated financial acumen and analytical skills
Proven ability to lead market strategies across relevant cross-functional teams and stakeholders
Ability to travel 25-35%25 of the time within assigned territories and markets

Nice To Haves

Experience in a Medicare Advantage or other government-funded healthcare business
In-depth experience with health care providers/ networks, HEDIS measures, Part D and clinical quality
Basic knowledge of STARs, CAHPS, HOS, RAF
Working knowledge of Medicare and/or Medicare Advantage
Reside in or willing to relocate to Pennsylvania, Delaware or Upstate New York
Excellent written, verbal, and interpersonal communication skills, with the ability to influence across a highly matrixed organization and present complex information to C-suite leaders, large groups, and media audiences
Proven track record of achieving business goals through disciplined, fact-based decision-making and timely execution
Strong organizational skills, flexibility, and ability to work effectively in ambiguous environments

Responsibilities

Defines and owns execution of the Stars strategy, utilizing both National and local initiatives, inclusive of HEDIS, Part D, CAHPS and HOS to achieve 80%25 of members in 4+ star plans
Defines and owns execution of the Provider Engagement strategy utilizing both National and local initiatives, establishes solid, collaborative relationships with providers in support of all Quality, NPS and Affordability goals; works collaboratively with Optum, UHN and UCS partners
Responsible for working cross-organizationally with local health plan team, Network, Market Medical Director and Optum to identify and execute new business opportunities, including bundled payment models, post-acute care innovation, and ACO acceleration and proliferation
Working cross-organizationally with local health plan team, Network, Market Chief Medical Officer and Optum to increase suspect closure, recapture, and prevalence improvement inclusive of increasing HouseCalls completion rates and reducing refusal rates
Achieving market-level NPS goals
Identifying and executing on Affordability opportunities aligned with market goals
Participate in defining and owning execution of the Growth and Retention strategy in partnership with Distribution; is the face of the market to external channels
Actively collaborates with all Medicare & Retirement national functions (Product, Sales, Marketing, Member Experience, Finance), UnitedHealthcare shared services functions (Network, Clinical, Quality, Operations) and Optum (Local Care Delivery, HouseCalls, Complex Population Management) functions to leverage local market knowledge and establish and drive plans across all levers of the P&L