Sr. Director, Medicare Advantage Product or Benefits

Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.

Caring. Connecting. Growing together.

Position Summary

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.

Primary 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

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications

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

Preferred Qualifications

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%

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 make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

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

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Worksite address

eden prairie, MN, 55344, US

Who can apply

Review the original listing for work authorization, qualifications and employer requirements.