Senior Business Manager, Risk Adjustment - San Antonio, TX

Unitedhealth Group Inc. San Antonio , TX 78245

Posted 2 months ago

The Senior Business Manager is responsible for managing, implementing and executing on key projects throughout Quality/Risk Adjustment (QRA). The position provides support through representation of senior leadership interests in both internal and external initiatives, and in some cases is an active team member on QRA strategy initiatives. This position requires a unique skill set that includes leading cross-functional leaders on complex projects, collaborating vertically and horizontally throughout the organization, understanding workflow, and creating a collaborative environment to work effectively throughout the organization to ensure alignment of strategy and approach. Accountable for supervising assigned projects and operational collaboration during implementation of new processes. Coordinates with project managers, program managers, business analysts, training teams, and other stakeholders to ensure all goals and objectives are met.

Primary Responsibilities:

  • Creates and executes Project plans and revises appropriately to meet changing requirements and needs

  • Plans and schedules Project timelines and milestones using the appropriate tools

  • Manages day-to-day operational and tactical activities of a Project

  • Develops and delivers Progress Reports, Proposals, Requirements Documentation and Presentations

  • Diagnoses task/procedural change issues and helps to resolve the problem

  • Develops and maintains strong relationships with both internal/externals customers, IT, enterprise wide business units, OptumCare Delivery Organizations and senior executives to influence project teams and gain consensus on the selection of the most viable solutions

  • Provides analysis, recommendations, and options to the VP, Risk Adjustment regarding decisions to be made or problems to be solved in internal or external meetings

  • Lead complex projects that require cross functional coordination. Works closely with all departments to accomplish mutual goals and strategies in order to achieve company goals

  • Understands and helps prioritize projects, business initiatives and strategic plans

  • Coordinate and manage WellMed QRA Advisory, Governance and Regional Reporting committees to include agendas with appropriate backup materials; take minutes, and provide follow-up correspondence

  • Serves as a SME for OptumCare for external organizational QRA reporting as needed. Set team direction, problem-solve and guide team members as needed

  • Identify and analyze trends, strategies and tactics to increase the productivity of the QRA teams to drive positive performance on organizational key performance metrics and improve the customer experience

  • Partner with key stakeholders to ensure projects are aligned with the goals and objectives of the business

  • Identify, develop, and present recommendations; lead implementation of approved solutions

  • Facilitates long-term planning and oversight to maintain operations of the Risk Adjustment Department assuring activities are appropriately integrated into the strategic direction of the business

Required Qualifications:

  • Bachelor's degree

  • 5 years of experience comprised of project coordination, project management, and business process improvement in an academic and/or job setting

  • Possession of strong analytical skills used in evaluating and analyzing data

  • Intermediate PC skills (Excel, PowerPoint, Word, and Outlook)

  • Experience with process mapping methodology and creating process maps

  • Ability to travel up to 25%

Preferred Qualifications:

  • Master's degree in Health Administration, Finance, Public Health or Business Administration
  • PMP or CAPM certification
  • 2 years of Healthcare or clinic operations experience

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 240,000 lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.

Diversity creates a healthier atmosphere: OptumCare 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.

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

Job Keywords: Senior Business Manager, Risk Adjustment, San Antonio, TX, Texas


icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Licensed Vocational Nurse LVN / LPN Pecan Valley Healthcare Wellmed San Antonio TX

Unitedhealth Group Inc.

Posted 4 days ago

VIEW JOBS 8/20/2019 12:00:00 AM 2019-11-18T00:00 There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm) Under the direction of providers (defined as an MD, DO, DPM, NP or PA) or RNs, the LVN/LPN provides clinical support functions and professional nursing care to patients using established standards of clinical nursing care and procedures approved by WellMed and applicable state board of nursing . Is an active member of the health care team to assess patients' needs, provide input into the plan of care and implement prescribed interventions. Primary Responsibilities: * Performs all nursing duties within the scope of a Licensed Vocational/Practical Nurse (procedures, injections, medication administration, EKGs, phlebotomy) as determined by the applicable State Board of Nursing. * Participates in implementing established education plans for patients and their families with common health problems and well defined health learning needs * Coordinates patient care as directed by providers, RNs, and policies, including referrals, transition visits, medications, procedures and follow up * Documents chief complaint and rooms patients according to policy and procedures, prepares patient for examination * Telephonically obtains information on chief complaint and symptoms and accurately relays information to provider * Collects data and performs "focused" nursing assessment of patients; assists in the evaluation of a patient's response to treatment and identifies patient's needs; communicates findings to the provider * Records patient assessment and care in the medical record in an accurate and timely manner * Reviews the patient record, chart, reports (including laboratory and x-ray), and other pertinent information for patients prior to being seen by the provider and reports relevant information to the provider and/or RN * Provides a safe environment (OSHA standards) for patients and staff in the clinic * Ensures patient confidentiality (HIPAA) at all times and treats patients with courtesy and respect * Organizes exam and treatment rooms, stocks and cleans rooms and sterilizes instruments * Practices standard infection control precautions * Ensures medication management follows policies and procedures; appropriately documents medications & immunizations in patient records * Follows laboratory management polices & procedures and CLIA standards; collects lab samples and ensures proper labeling * Fulfills medication refill requests following approved protocols * If certified in IV therapy; starts peripheral lines, monitors and adjusts flow rates, prime IV lines, changes dressing on IV sites (if needed) and discontinues venous lines * Performs all other related duties as assigned WellMed at Pecan Valley – E. Southcross St. 78222 / near the old SE Baptist Hospital and WW White Rd. Required Qualifications: * High school diploma or GED * Current and unrestricted State Vocational/Practical Nursing license * Current CPR and/or BLS certification or ability to obtain within 30 days * Knowledge of medical terminology and medical office procedures * Proficient computer skills to work efficiently with electronic medical records * Ability to perform medical procedures, give injections and perform phlebotomy * If required by clinic, IV certification must be obtained * This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease Preferred Qualifications: * 2 years of experience in a medical setting * IV certification * Knowledge of ICD-10 and CPT coding * Effective listening and communication skills; proper use of grammar and spelling * Ability to react calmly and effectively in emergency situations * Ability to establish and maintain effective working relationship with providers/staff, patients, and the community * Good communication and customer service skills Physical & Mental Requirements: * Ability to lift up to 35 pounds * Ability to push or pull heavy objects using up to 35 pounds of force * Ability to use fine motor skills to operate equipment and/or machinery * Ability to receive and comprehend instructions verbally and/or in writing * Ability to use logical reasoning for simple and complex problem solving * Occasionally requires exposure to communicable diseases or bodily fluids Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 350,000 lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm) Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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. Job Keywords: WellMed, Healthcare, Bilingual, Licensed Vocational Nurse, LVN/LPN, Medical Terminology, ICD-9 and CPT coding, San Antonio, New Braunfels, Seguin, Gonzales, Shiner, Yoakum, Boerne, Floresville, Helotes, Pecan Valley, 78222, Texas, TX Unitedhealth Group Inc. San Antonio TX

Senior Business Manager, Risk Adjustment - San Antonio, TX

Unitedhealth Group Inc.