At UnitedHealthcare, 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 has primary responsibility for defining, leading and driving local initiatives to achieve five Star CMS ratings, 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. The executive director establishes and maintains clear leadership credibility and partnership with our external provider and broker partners.
This role is responsible for identifying and leading new business strategies and initiatives to meet the needs of our members. Additionally, this role will address provider issues while working with multiple levels of staff across multiple functional areas across one or more business departments. These strategies will impact Medicare Advantage product development and planning, new business ventures, and market expansion.
If you are located in, or willing to relocate to Pennsylvania, Delaware, or Upstate New York, you'll enjoy the flexibility to work remotely* as you take on some tough challenges. Pennsylvania is preferred.
Primary Responsibilities:
- Defines and owns execution of the Stars strategy, utilizing both National and local initiatives, inclusive of HEDIS, Part D, CAHPS and HOS to achieve 80% of members in 4+ star plans
- Defines and owns execution of the Provider Engagement strategy utilizing both National and local initiatives, establishes solid, collaborative relationships with providers in support of all Quality, NPS and Affordability goals; works collaboratively with Optum, UHN and UCS partners
- Responsible for working cross-organizationally with local health plan team, Network, Market Medical Director and Optum to identify and execute new business opportunities, including bundled payment models, post-acute care innovation, and ACO acceleration and proliferation
- Working 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 HouseCalls completion rates and reducing refusal rates
- Achieving market-level NPS goals
- Identifying and executing on Affordability opportunities aligned with market goals
- Participate in defining and owning execution of the Growth and Retention strategy in partnership with Distribution; is the face of the market to external channels
- Actively collaborates with all Medicare & Retirement national functions (Product, Sales, Marketing, Member Experience, Finance), UnitedHealthcare shared services functions (Network, Clinical, Quality, Operations) and Optum (Local Care Delivery, HouseCalls, Complex Population Management) functions to leverage local market knowledge and establish and drive plans across all levers of the P&L
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:
- 7+ years of healthcare or health plan experience
- 5+ years of experience working with hospitals and physicians
- Demonstrated success building and managing relationships with external executives and stakeholders, including maintaining ongoing communication with CEOs, CMOs, and CFOs to drive performance and represent UHC
- Demonstrated financial acumen and analytical skills
- Proven ability to lead market strategies across relevant cross-functional teams and stakeholders
- Ability to travel 25-35% of the time within assigned territories and markets
Preferred Qualifications:
- Experience in a Medicare Advantage or other government-funded healthcare business
- In-depth experience with health care providers/ networks, HEDIS measures, Part D and clinical quality
- Basic knowledge of STARs, CAHPS, HOS, RAF
- Working knowledge of Medicare and/or Medicare Advantage
- Reside in or willing to relocate to Pennsylvania, Delaware or Upstate New York
- Excellent written, verbal, and interpersonal communication skills, with the ability to influence across a highly matrixed organization and present complex information to C-suite leaders, large groups, and media audiences
- Proven track record of achieving business goals through disciplined, fact-based decision-making and timely execution
- Strong organizational skills, flexibility, and ability to work effectively in ambiguous environments
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $159,300 to $273,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.
UnitedHealth Group and its affiliated brands are 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.
UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Skills Required
- 7+ years of healthcare or health plan experience
- 5+ years of experience working with hospitals and physicians
- Demonstrated success building and managing relationships with external executives and stakeholders, including CEOs, CMOs, and CFOs
- Demonstrated financial acumen and analytical skills
- Proven ability to lead market strategies across cross-functional teams and stakeholders
- Ability to travel 25-35% of the time within assigned territories and markets
- Experience in Medicare Advantage or another government-funded healthcare business
- In-depth experience with healthcare providers and networks, HEDIS measures, Part D, and clinical quality
- Basic knowledge of Star ratings, CAHPS, HOS, and RAF
- Working knowledge of Medicare or Medicare Advantage
- Reside in or be willing to relocate to Pennsylvania, Delaware, or Upstate New York
- Excellent written, verbal, and interpersonal communication skills, including influencing in matrixed organizations and presenting to executives, groups, and media
- Proven track record of achieving business goals through disciplined, fact-based decision-making and timely execution
- Strong organizational skills, flexibility, and ability to work effectively in ambiguous environments
Optum Compensation & Benefits Highlights
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Leave & Time Off Breadth — PTO is generally described as decent or good, and many note it as a strong part of the package. Actual ability to take time off can depend on workload and team coverage.
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Retirement Support — Offerings include a 401(k) with employer match and access to an employee stock purchase plan, which are highlighted as meaningful components of total rewards. These programs are consistently referenced among core benefits.
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Parental & Family Support — Parental and caregiver leave, along with adoption assistance, are publicly highlighted and viewed as notable elements of the package. Availability can be role-specific, but these supports contribute to overall breadth where offered.
Optum Insights
What We Do
Optum, part of the UnitedHealth Group family of businesses, 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. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.
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Optum Offices
Hybrid Workspace
Employees engage in a combination of remote and on-site work.
Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.