Executive Director, Medicare & Retirement Texas

** Requisition number:
** 2392881

** Job category:
** Business Operations

At United Healthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us in making healthcare work better for everyone through people-led, responsible AI while  
** Caring. Connecting. Growing together.*
* The Medicare & Retirement Executive Director is accountable for all aspects of the P&L within a given market, with primary responsibility for defining, leading and driving local initiatives to achieve five Star CMS rating, Coding, Growth, Building Medicare networks, Retention of Medicare members and Affordability goals. The Executive Director sets strategy and prioritization with national shared service partners specific to the local market and ensures cross-organizational alignment.

In this role, you are the face of M&R in your market. You will establish and maintain clear leadership credibility and partnership with our external provider and broker partners.  You are responsible for identifying and leading new business strategies and initiatives to meet the needs of our members. These strategies will impact Medicare Advantage product development and planning, new business ventures, and market expansion.

This role will report directly to the Health Plan CEO.

If you are located in Texas, you will have the flexibility to work remotely
* as you take on some tough challenges.

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* Primary Responsibilities:

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* + Serve as the Medicare market strategist of market health care delivery, business development, payment model innovation, and policy integration, establish have solid provider partner relationships

+ Actively collaborate with all Medicare & Retirement national functions (Product, Sales, Marketing, Member Experience, Finance), United Healthcare shared services functions (Network, Clinical, Quality, Operations) and Optum (Local Care Delivery, House Calls, Complex Population Management) functions to leverage local market knowledge and establish and drive plans across all levers of the P&L

+ Define and own execution of the Provider Engagement strategy utilizing both National and local initiatives; establish solid, collaborative relationships with providers in support of all Quality, NPS and Affordability goals; work collaboratively with Optum, UHN and UCS partners

+ Work cross-organizationally with local health plan team, Network, Market Medical Director and Optum Stars to identify and execute new business opportunities, including bundled payment models, post-acute care innovation, and ACO acceleration and proliferation

+ Work cross-organizationally with local health plan team, Network, Market Chief Medical Officer and Optum to increase suspect closure, recapture, and prevalence improvement inclusive of increasing House Calls completion rates and reducing refusal rates

+ Provider contract set up and offerings - Capitation, delegation, risk, FFS, MAPCPi/MCAIP, ACO, MAIP

+ Assist UHN and roster managers with provider loading and accuracy of information  - Sign off on loading instructions, source of truth and breakout documents

+ Involvement in provider facing JOC meetings to discuss market performance, strategy around STARS, CAHPS, HOS and RAF. Partner with internal teams of QFO, ACO and Optum to drive goals

+ Identify and execute on Affordability opportunities aligned with market goals

+ Participate in defining and owning execution of the Growth and Retention strategy in partnership with Distribution; be the face of the market to external channels

+ Act as the…