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Growing together. The Medicare & Retirement Executive Director is accountable for all aspects of the P&L within a given market, with primary responsibility for defining, leading and driving local initiatives to achieve five Star CMS rating, 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.
In this role, you are the face of M&R in your market. You will establish and maintain clear leadership credibility and partnership with our external provider and broker partners. You are responsible for identifying and leading new business strategies and initiatives to meet the needs of our members.
These strategies will impact Medicare Advantage product development and planning, new business ventures, and market expansion. This role will report directly to the Health Plan CEO. If you are located in Texas, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary
Serve as the Medicare market strategist of market health care delivery, business development, payment model innovation, and policy integration, establish have solid provider partner relationships Actively collaborate 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 Define and own execution of the Provider Engagement strategy utilizing both National and local initiatives; establish solid, collaborative relationships with providers in support of all Quality, NPS and Affordability goals; work collaboratively with Optum, UHN and UCS partners Work cross-organizationally with local health plan team, Network, Market Medical Director and Optum Stars to identify and execute new business opportunities, including bundled payment models, post-acute care innovation, and ACO acceleration and proliferation Work 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 Provider contract set up and offerings - Capitation, delegation, risk, FFS, MAPCPi/MCAIP, ACO, MAIP Assist UHN and roster managers with provider loading and accuracy of information - Sign off on loading instructions, source of truth and breakout documents Involvement in provider facing JOC meetings to discuss market performance, strategy around STARS, CAHPS, HOS and RAF.
Partner with internal teams of QFO, ACO and Optum to drive goals Identify and execute on Affordability opportunities aligned with market goals Participate in defining and owning execution of the Growth and Retention strategy in partnership with Distribution; be the face of the market to external channels Act as the voice of the market for print and media interviews Help define and support execution of the Stars strategy, utilizing both National and local initiatives, inclusive of HEDIS, Part D, CAHPS and HOS to achieve 80% of members in 4+ star plans Identify and prioritize market barriers both internally and externally to enable teams to be more productive.
Ability to work quickly and independently to ensure quality, coding and utilization stays on trend 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
5+ years of experience in a large, complex and successful health care / managed care organization with demonstrated track record of increasing responsibility and / or accountability In-depth experience with health care providers / networks, CMS Star ratings, HEDIS measures, Part D and / or clinical quality Demonstrated success building relationships with external executives and stakeholders Proven track record of meeting business goals via driving disciplined, fact-based decisions and executing with discipline and urgency Proven solid written and verbal communication skills, including well-developed interpersonal skills used to influence the behavior of others across a highly matrixed organization Demonstrated intermediate or higher level of proficiency with MS PowerPoint and Excel and new AI tools to help create operational efficiencies Proven ability to present complex information to C-Suite Leadership Ability to travel 25-35% of the time within an assigned territory Reside in Texas
Experience in Medicare Advantage or other government-funded healthcare business Demonstrated financial acumen and solid analytical skills Demonstrated excellent written and verbal communication skills, including well-developed interpersonal skills used to influence the behavior of others across a highly matrixed organization *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc.
In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $159,300 - $273,200 annually based on full-time employment.
We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve.
We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives. UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.