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Executive Director, Health Care Economics, Optum MA

3 months ago

Worcester, Massachusetts, United States UnitedHealth Group Full time
Opportunities with Reliant Medical Group, part of the Optum family of businesses. Join a community-based, multi-specialty, physician-led organization where you will work with talented peers on a common purpose: improving the quality, cost and experience of health care. Here, we focus on delivering the best patient care, rather than volume. Through innovation and superior care management, we support patients and your well-being as a team member. Join a team at the forefront of value-based care and discover the meaning behind Caring. Connecting. Growing together.

Under the direction of the Chief Financial Officer, Optum Massachusetts, the Executive Director, Health Care Economics (d.b.a., Optum Massachusetts) is responsible for leading all aspects of financial responsibilities related to the managed care model of Optum MA.

The ideal candidate would work a hybrid schedule in one of our Massachusetts offices but we are also open to remote candidates as well in other locations

Primary Responsibilities:
  • Responsible for reporting on capitation revenue, including funds flow, tracking, analytics and work papers to support forecasts, budget and month-end close
  • Manages the tracking, reporting, forecasting, analytics, measurement of outside medical expenses, in partnership with actuarial team
  • Leads affordability initiatives through tracking, reporting, analytics and measurement; in partnership with HCE
  • Directs the reporting, forecasting of non-claims accounts like truncation, reinsurance, rebates, discounts, etc. of all other outside medical expenses
  • Oversees the reconciliation of medical expenses as reported through settlements/dashboards
  • Ensures that monthly reporting including enrollment, financial claims, and lines of business reports are produced on the approved schedule
  • In partnership with IT, leads data warehouse efforts, including system administration, data integration and other pertinent reports as requested
  • Participates in and assists with financial systems integration activities with Optum
  • Assists in transition of Atrius and Reliant finance teams to statewide structure
  • Seeks out, explores and identifies opportunities for advancing business interests and works with various clinical and non-clinical departments to assess feasibility of potential initiatives and projects
  • Performs other duties as assigned
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 Qualifications:
  • Bachelor's degree (or equivalent experience) required, preferably in accounting, finance, mathematics or actuarial science
  • 10+ years of experience in financial data analysis including 3 years of experience in a managerial, supervisory or lead role
  • Experience in healthcare or health insurance
  • Background in financial modeling and forecasting
  • Demonstrated project management skills and attention to detail
  • Microsoft Excel and Access proficiency and experience in computer-based modeling
Preferred Qualifications:
  • MBA
  • Actuarial Certification
  • Knowledge of provider/facility contracting
  • Experience in a supervisory or lead role
  • Excellent analytical and quantitative skills including statistical analyses
  • Detail oriented with solid technical writing, communication and presentation skills
  • Ability to build relationships and negotiate with external (payers and providers) and internal (finance, contracting, medical management, data warehouse) customers and develop a strong case for positive financial and other outcomes
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $122,100 to $234,700 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

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