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Healthcare Program Manager

2 months ago

Hialeah, Florida, United States Optum Full time
Job Overview

Join Optum, a leader in health care innovation and analytics. We are dedicated to reshaping the health care landscape through advanced technology and data-driven solutions. Explore a variety of career paths that contribute to meaningful health care transformation, ultimately enhancing the well-being of communities.


The Manager of Field Services plays a pivotal role in overseeing operations and ensuring exceptional customer service across designated facilities within a specific region. Reporting directly to the Director of Operations, this position involves leading a team of Healthcare Representatives to provide top-tier service to assigned clients. Collaboration with field leadership and other departments within Optum is essential for success.


Key Responsibilities:

  • Operational Leadership
    • Directs a team of Healthcare Representatives to deliver high-quality, client-focused services by leveraging knowledge of local, state, and federal regulations to maintain and update applicant information efficiently.
    • Ensures timely submission and resolution of claims, with appropriate documentation of claim status in the system.
    • Reviews inventory reports and takes necessary actions while providing constructive feedback to team members.
  • Reporting and Analysis
    • Provides insights and recommendations based on performance metrics for the assigned territory.
    • Ensures adequate coverage within the designated area.
    • Maintains effective communication with government agencies regarding claim statuses.
    • Manages customer relationships in compliance with Optum policies and relevant regulations.
  • Team Development
    • Encourages teamwork by fostering collaboration among team members and leading by example.
    • Effectively manages change, supporting innovation and organizational improvements.
    • Sets clear performance goals and expectations, monitors progress, and addresses any performance issues promptly.
    • Communicates essential information to ensure all team members are informed.
    • Mentors team members by delegating responsibilities and providing coaching to enhance their skills and capabilities.
    • Collaborates with team members on professional development and growth opportunities within Optum.
    • Partners with Talent Acquisition to identify and recruit top talent as staffing needs arise.
    • Builds and nurtures relationships with internal and external partners to facilitate information sharing and support.


Work Environment: This position requires onsite presence with potential travel to various facilities as necessary.


Employees will be recognized for their contributions in a challenging environment that provides clear direction for success and opportunities for professional growth.

Qualifications:

  • Minimum of 3 years of experience in Medicaid, disability, Social Security, or healthcare.
  • Experience in a clinical or hospital setting.
  • Proficient in Microsoft Office Suite (Excel, Word, PowerPoint) and comfortable using tablets.
  • Access to reliable transportation.


Preferred Qualifications:

  • At least 2 years of experience as a Patient Advocate or Healthcare Representative.
  • Experience in managing teams.
  • In-depth knowledge of SSA/SSI disability and various federal and state assistance programs.
  • Basic understanding of budgeting and financial principles.
  • Strong communication skills across diverse audiences.
  • Exceptional customer service abilities.
  • Demonstrated decisiveness and sound judgment in various situations.
  • Strong organizational skills and follow-up capabilities.
  • Ability to work collaboratively within a team environment.


Optum is committed to creating a diverse and inclusive workplace. We are an Equal Employment Opportunity/Affirmative Action employer and welcome applicants from all backgrounds.

Optum maintains a drug-free workplace. Candidates may be required to undergo drug testing prior to employment.