Director of Payor Engagement
Optum
Job Description
Director of Payor Engagement - California
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Director of Payor Engagement - California
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For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.
Optum CA is redefining health care with a focus on health equity, affordability, quality, and convenience. At Optum CA, we care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions.
Director of Payor Engagement will be the liaison between the Payors and Optum shared services, and operations. They will provide a centralized party/team or “one stop shop” to intake issues and concerns from the various payors and coordinate solutions and responses from the various shared services and operations teams. This role will also help drive performance of underlying contracts and maintain Optum Health California as the “provider of choice” for payors
If you are located in CA, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities
- Managing payor engagement activities, such as Joint Operations Meetings (JOMs) with Optum CA Payors. The Director will lead preparation for JOMs in collaboration with Payor Contracting, as well as with the Population Health team related to STAR scores and Risk Adjustment Factor
- The Director will also have responsibility for developing the Payor Engagement Team. More specifically, the Director will recruit and hire team members to support the various activities as needed. It is contemplated that the Director will have one to two associates for support
- The Director will define quantifiable KPIs that demonstrate ROI and success of the Payor Engagement Team. The Director will develop the tools and dashboards necessary to track and report progress to Optum CA leadership and other stakeholders on a defined cadence
- The Director will also develop a Payor Satisfaction Survey based on NPS methodology. Director and Associates with tabulate results and present findings
- In the event the Payor Contracting requires help due to call outs or vacation of staff, the Payor engagement team will perform the necessary administrative tasks
- The Director will identify, track and drive resolution of payor requests, partnering with multiple functions in a matrixed environment to ensure forward momentum and resolution on requests that will range from simple to very complex
- Will make and enact recommendations to continuously create process improvement in areas of Payor Engagement
Required Qualifications
- Experience in a leadership capacity within the Payor environment
- Experience in a leadership capacity within an IPA or large medical group that is a risk bearing entity
- Understanding of HMO Products, Risk Adjustment Factor, and Five Star Measures
- Proven solid customer service orientation with incredible attention to detail and rapid follow up
- Must reside in CA
- Ability to travel (mostly CA Locally) up to 20%
- Driver’s License and access to reliable transportation
- All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
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.
OptumCare 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Seniority level
Seniority level
Director
Employment type
Employment type
Full-time
Job function
Job function
Business Development and SalesIndustries
Hospitals and Health Care
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