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. Join us to start Caring. Connecting. Growing together.
Positions in this function include those responsible for management and administration of multiple functions, or management of general business operations. May manage the P&L of a business or part of a business unit. Manage daily operations of multiple levels of staff and multiple functions/departments across one or more business units. May include day to day site operations, management leadership internal and external to organization, accountable for financial and non-financial results (budgets and actuals). Project management and implementation, staff management.
Position in this function provides leadership to and is accountable for the performance and direction through multiple layers of management and senior level professional staff. Work most often impacts a large business unit, or multiple markets/sites.
Primary Responsibilities:
- Develops and executes strategies for a function or discipline that span a large business unit or multiple markets/sites
- Directs others to resolve business problems that affect multiple functions or disciplines
- Product, service or process decisions are most likely to impact multiple functions and/or customer accounts (internal or external)
- Utilize standard project plan templates to create and/or tailor project plans to specific customers needs
- Analyze RFP/contract language and incorporate requirements into project plans
- Assist internal and/or external business partners with completion of tasks and resolution of issues and problems with program implementation
- Establish and/or implement internal and/or external service level agreements in order to ensure ability to monitor and measure program performance (e.g., turnaround time; quality; effectiveness)
- Identify and/or secure resources (e.g., funding; staffing; system security; real estate and/or telecommuting requirements; hardware/software) required to implement programs
- Review, create, and/or maintain workflows to ensure they are up-to-date and operationally efficient-Provide guidance, expertise, and/or assistance to internal and/or external partners (e.g., claims; call center; benefits; clinical) to ensure programs and strategies are implemented and maintained effectively
- Communicate with and help internal and/or external partners interpret contractual requirements in order to ensure effective problem solution and strategy implementation
- Provide input to internal and/or external stakeholders (e.g., sales; shared business partners; pre-service vendors; facilities) in order to drive effective business plan and sales strategy development
- Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
Required Qualifications:
- 15+ years of experience and 10 years in leadership capacity
- Experience in Utilization Review, Enrollment and Billing
- Experience in managing monthly financials
- Experience in creating and delivering executive level presentations
- Experience in managing call center performance with the ability to build performance remediation plans focused on resolving the root cause issues
- Experience in negotiating contract terms and working through financial considerations/disputes with outside suppliers
- Extensive experience in Payment Integrity and Clinical Operations
- Relevant work experience in strategy, management consulting, product or general management in a health care related field
- Solid history of quickly gaining credibility, partnering with business leaders and exhibiting executive presence
- Proven excellent oral and written English Communication Skills
- Proven ability to articulate business strategies and formulate concise solutions to complex problems
- Proven ability to champion continuous change, consult with versatility, exhibit personal leadership and model a customer orientation
- Proven ability to effectively drive results in a dynamic, matrixed environment with a high degree of organizational change, growth and ambiguity
- Willing to be assigned in QC/McKinley/Alabang
- Ability to work a US Shift schedule
- Hybrid Work Set-up, willing to report onsite
