Georgia Medicare Executive Director - Atlanta, GA
About the Job
If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm)
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. Is the face of M&R in his/her market. Establishes and maintains clear leadership credibility and partnership with our external provider and broker partners. Recruits, retains and nurtures top talent. Promotes Our United Culture. Drives innovation. Is externally focused and facing. Additionally, this role will be 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.
- Defines and owns execution of the Provider Engagement strategy; establishes strong, collaborative relationships with providers in support of all Quality, NPS and Affordability goals; works collaboratively with Optum, UHN and UCS partners
- Defines and owns execution of the Growth and Retention strategy in partnership with Distribution; is the face of the market to external channels
- Defines and owns execution of the Stars strategy inclusive of HEDIS, Part D and CAHPS to achieve 80% of members in 4+ star plans
- Stars strategy inclusive of HEDIS, Part D and CAHPs to achieve 85% of members in 4 star plans.
- Must be able to demonstrated ability of 5+ years of experience in Medicare with a concentration on Stars market leading levels at 4+ stars
- Responsible for working cross-organizationally with local health plan team, Network, Market Medical Director and Optum to increase suspect closure, recapture, and prevalence improvement inclusive of increasing HouseCalls completion rates and reducing refusal rates
- Responsible for achieving market-level NPS goals
- Responsible for identifying and executing against Affordability opportunities aligned with market goals
- Act as voice of the market for print and television interviews
- 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
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.
- Bachelor's degree in business management or healthcare related field
- 10+ years of experience in a large, complex and successful health care / managed care organization with demonstrated track record of increasing responsibility and accountability
- 10+ years as a manager with direct reports who drives performance
- 8+ years of experience in Medicare provider contracting including demonstration of contracting with hospital CEOs/CFOs
- 5+ years of proven experience with Medicare Advantage filing of bids and creation of benefit packages that will lead to double digit growth and high member NPS scores
- In-depth experience with health care providers/ networks, CMS Star ratings, HEDIS measures, Part D and clinical quality
- Track record of meeting business goals via driving disciplined, fact - based decisions and executing with discipline and urgency
- Demonstrated strong financial acumen and analytical skills
- Demonstrated excellent communication skills – ability to speak to large groups and television interviews as well
- Proven organizational skills with ability to be flexible and work with ambiguity
- Master’s degree
- Bachelor’s degree with a major in business, marketing, economics, health or public policy
- Experience in a Medicare Advantage or other government-funded healthcare business
- Strong written and verbal communication skills, including well-developed interpersonal skills used to influence the behavior of others across a highly-matrixed organization
- Demonstrated success building relationships with external executives and stakeholders
- Track record of meeting business goals via driving disciplined, fact-based decisions and executing with discipline and urgency
Careers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in health care. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.(sm)
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: Atlanta, Georgia, GA