Sr. Director, Medicare Advantage Product or Benefits

UnitedHealth Group•Eden Prairie, MN

10d•$159,300 - $273,200•Remote

About The Position

The Optum Health Enterprise Payer Team is responsible for owning, driving, and optimizing Optum Health’s payer portfolio to achieve sustainable value-based care relationships. The Senior Product and Benefits Director will play a critical role in developing strategies to successfully position Medicare Advantage products within Optum Health value-based care arrangements including benefit design and planning, sales distribution relationships, identifying best practices, and AEP/OEP/SEP payer performance. This individual will be expected to: Be the subject matter expert for Medicare Advantage benefits and products including product management, product definition, risk identification, standard benefit models, and financial and regulatory impacts Own the Optum Health strategic analysis of Medicare Advantage benefit design and planning Provide quantitative and qualitative interpretation of AEP payer performance to help advance Optum Health goals Understand CMS required deadlines and quality requirements for Medicare Advantage products and programs Understand the scope and strategy for bid submission, including defining standard benefit models and alignment to product strategy Foster relationships with cross-functional partners to solve critical business initiatives Proactively identify problems and develop recommended solutions This individual will need to be able to function in a diverse environment with varying level stakeholders across internal and external stakeholder groups, abstract and fluid environments, and simultaneous deadlines. The position requires an ability to comprehend Medicare Advantage, local markets’ strategies while demonstrating awareness of broader systems across the enterprise, both strategically and tactically. Organizational agility will be required – building meaningful relationships and facilitating decision-making to continue achieving Optum Health’s value-based care agenda.

Requirements

10+ years of experience in healthcare strategy, Medicare, product management, innovation, or consulting
5+ years of health plan or Medicare Advantage experience
Expert knowledge of Medicare Advantage benefits and products including product management, product definition, risk identification, standard benefit models, and financial and regulatory impacts
Experience with Medicare Advantage bid filings
Demonstrated ability to achieve high performance by utilizing resources in a matrix environment
Demonstrated ability to work with and communicate with all levels of the organization
Proven solid analytical skills

Nice To Haves

Knowledge of Medicare Stars, HEDIS, value-based care models, provider incentives, care gap closure, supplemental data exchange, pharmacy quality, affordability/utilization, and provider engagement operations
Experience working with Actuarial and Underwriting teams
Proven ability to achieve superior results in a performance-oriented environment
Proven ability to work with all levels of management across all functions and business partners
Demonstrated problem solving, analysis, and resolution at strategic and functional levels
Demonstrated ability to manage competing priorities and a rapidly changing business environment
Demonstrated excellent written and verbal communication skills
Willingness to travel up to 20%25

Responsibilities

Lead end to end benefit strategy for all payers across Medicare Advantage plans
Create solid relationships with payer product teams to align membership strategies with enterprise financial performance targets
Analyze benefit performance/ROI and develop investment recommendations
Partner with Health Care Economics and Actuarial teams to ensure MACVAT data is completed and correct prior to socialization with key regional partners
Conduct in-depth analysis and strategic summary of AEP results
Identify key benefit battleground states and areas of greatest risk and opportunity along with key market insights
Ensure cross functional collaboration with finance and HCE to quantify benefit decision impact
Partner with local growth and marketing teams on broker/partnership strategy and execution, to unify capabilities where possible and create a cohesive approach
Develop and socialize specific AEP strategies with leadership and provide market feedback
Develop executive materials for overall benefit strategies and approach
Collaborate with care delivery and Optum at Home to build risk programs that strengthen overall market positioning and advance Optum’s value prop to further differentiate for consumers and partners
Synthesize market, competitor, regulatory, financial, and operational intelligence to inform priorities, decisions, and future innovation opportunities