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Reporting to the ExecutiveDirector of Operations, the Associate Director Service Account Management willhave a dotted line to the local Market President and will serve as anindividual contributor– while working closely with the operational departmentheads. The Associate Director will act as an Operations subject matter expertin working with the growth team and local leadership. The Associate Directorwill provide guidance regarding feasibility of implementing proposed riskcontracts, educate potential and existing clients regarding capabilities, andensure a close connection between local market needs and operationalcapabilities and capacity. 

The Associate Directorwill sit in the local market office and will be responsible for maintaining ahigh level of satisfaction from the local leadership teams regarding Operationsperformance, and overall responsiveness and attention from Operations.

Primary Responsibilities:

• Act as the primary senior contact for local issues related to our shared service operations (service, claims, eligibility, utilization management, prior authorization, payment integrity, provider data management, configuration, IT, project management, etc.)
• Work collaboratively with the heads of centralized operations regarding local market issues
• Accountable for ensuring the shared services operating metrics consistently meet and/or exceed all compliance requirements as well as key performance targets and associated service level agreements established with the local Market
• Work with staff and senior management to develop and implement improvements and oversight for all operational areas that impact performance
• Act as advocate for local market needs and influence change within Operations to meet customer needs
• Act as an advocate for Operations when influence is needed within the local market team
• Develop relationships with the local provider community
• Educate providers on billing issues, portal navigation, claims policies, and other information
• Work with Operations leadership to design innovative ways to enhance our service model and improve customer satisfaction
• Directs analytical activities to identify trends and potential opportunities within our Shared Service Operations functions that may impact the affordability of the local Market

• 7+ years of direct health plan operations experience (health plan or payer) 
• 7+ years of implementation and/or project management experience
• 7+ years client relationship and/or conflict resolution experience
• Experience executing formal change management techniques
• Experience leading process improvement initiatives without direct authority
• Experience creating and monitoring performance scorecards and/or performance metrics
• Experience driving and executing customer focused strategies
• Demonstrated adaptability and flexibility to a rapidly moving business environment

PreferredQualifications:

• Bachelor’s degree
• Medicare Advantage experience
• Operational healthcare experience
• Six sigma certified 

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare’s support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

Job Keywords: Health Plan Operations, Las Vegas, Nevada, NV