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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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Director of MPP Engagement, provides leadership and oversight for MPP contract arrangements under Optum Physician Advisor Services.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Oversight for overall MPP OPAS performance and achievement of contractual SLA goals

• Facilitate workflow for centralized resources, clinical & non-clinical, who engage with onsite client clinical staff to deliver a streamlined UM process flow and best-in-class client experience for each individual MPP

• Lead and drive new Integrated Utilization Management and UM component of the Hospital Case Management product launches and advancement in partnership with product, technology and other cross-functional partners

• Engage monthly with MPP Hospital client leadership team to present on OPAS UM performance or Physician Advisor services, address escalated issues and build a relationship that sustains client engagement

• Monitor trends for each MPP and for new product offering launches and partner with product to evolve model

• Engage with cross functional teams to develop and refine UM and Physician Advisor workflows for all functional areas, manage client experience, drive product advancement, and deliver on operational goals

• Partner with both product and MPP deal teams to refine deal pipeline and solution design

• Own and drive operational readiness activities for MPP in coordination with the OPAS Implementation team

• Execute on staff rebadge and initial contract launch for new MPP deals

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:

• Registered Nurse with active license, with expectation to maintain licensure

• 10+ years utilization management (UM) management leadership experience. Preferably within an onsite hospital facility clinical setting

• 8+ years people leadership experience

• Client engagement experience

• Proven understanding of key hospital metrics with expertise in UM; ability to track metrics during implementation, and improve upon them thereafter

• Demonstrated solid data analysis skills

• Demonstrated ability to lead new product lines with clients and make decisions with little to no oversight

• Physician Advisor Second level admission review experience

• Denials management experience including inpatient medical necessity denials and DRG downgrades.

Preferred Qualifications:

• Proven highly polished client-facing communication skills

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington 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: UnitedHealth Group 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.

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