Health Services Director - Remote in Wisconsin

Posted 6 Hours Ago
Be an Early Applicant
Hiring Remotely in Milwaukee, WI, USA
In-Office or Remote
135K-231K Annually
Senior level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Lead and manage statewide Health Services team and clinical operations for a health plan. Accountable for clinical quality, case management, disease and utilization management, policy support, and stakeholder engagement to improve member outcomes across multiple programs and geographies.
Summary Generated by Built In
Requisition Number: 2369599
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 to start Caring. Connecting. Growing together
This position is responsible for the management and administration of multiple Medical & Clinical Operations Functions or managing general operations which are not specific to one of the functions in the Medical & Clinical Operations job family.
If you are located in Wisconsin, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
  • Provides leadership to and is accountable for the performance and direction of the Health Services team and other senior level professional staff that results in high quality healthcare and positive outcomes for our members
  • Work and responsibilities will impact the health and wellbeing of statewide membership across multiple programs and broad geographies

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:
  • Must possess one of the following:
    • Active and unrestricted RN licensure in WI
    • Licensure in Social Work
    • 8+ years of health plan experience
  • 5+ years of experience in managed care
  • 5+ years of clinical practice in a hospital, clinic, home care, or nursing home setting
  • 5+ years of experience managing direct reports, both clinical and nonclinical staff
  • Case management experience
  • Disease and utilization management experience
  • Proven ability in organization, ability to prioritize and delegate, and ability to maintain forward momentum in overall progress
  • Resident of Wisconsin

Preferred Qualifications:
  • CCM Certified
  • Experience supporting Long Term Services and Supports (LTSS)
  • Experience in policy development or policy analysis
  • Experience in contributing to the overall health plan strategy that achieves business objectives and support efforts towards affordability goals
  • Proven to display a high degree of organization, ability to prioritize and delegate, and ability to maintain forward momentum in overall progress
  • Demonstrate critical leadership and management skills that develop positive working relationships with staff, with an emphasis on empowerment and positive motivation
  • Demonstrate solid written and verbal communication skills
  • Demonstrate the ability to work with all levels of key stakeholders, from member-facing front line staff to CEO, and national UHC leaders
  • Demonstrate ability to clearly present to, and communicate with, state partners to support clinical and system thought leadership and to identify, address and resolve potential issues

*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 $134,600 - $230,800 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 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.
UnitedHealth Group 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.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Skills Required

  • Active and unrestricted RN licensure in WI
  • Licensure in Social Work
  • 8+ years of health plan experience
  • 5+ years of experience in managed care
  • 5+ years of clinical practice in a hospital, clinic, home care, or nursing home setting
  • 5+ years of experience managing direct reports, both clinical and nonclinical staff
  • Case management experience
  • Disease and utilization management experience
  • Proven ability in organization, ability to prioritize and delegate, and ability to maintain forward momentum
  • Resident of Wisconsin
  • CCM Certified
  • Experience supporting Long Term Services and Supports (LTSS)
  • Experience in policy development or policy analysis
  • Experience contributing to overall health plan strategy and affordability goals
  • Demonstrated leadership and management skills that develop positive working relationships and motivate staff
  • Demonstrated solid written and verbal communication skills
  • Ability to work with all levels of key stakeholders, from front line staff to CEO and national leaders
  • Ability to present to and communicate with state partners to support clinical and system thought leadership

What the Team is Saying

Optum Compensation & Benefits Highlights

  • Healthcare Strength Official materials highlight copay and HSA medical plan choices with in‑network preventive care at 100%, prescription coverage, and low/no‑cost virtual visits, plus company HSA contributions. Dental preventive services are 100% in network, and mental health resources include an EAP and premium Calm access.
  • Parental & Family Support Programs include six weeks paid parental leave, up to two weeks paid caregiver leave, and Bright Horizons back‑up care with enhanced family supports. Adoption assistance up to $10,000 for full‑time employees reinforces family‑oriented benefits.
  • Equity Value & Accessibility Financial benefits include an Employee Stock Purchase Plan at a 10% discount, expanding access to equity ownership.

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

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.

Typical time on-site: Not Specified
HQEden Prairie, MN
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