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Wilmington, Delaware UnitedHealth Group

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

The Sr. Operations Manager, Heath Plans will serve as the manager for ongoing contract relationships and service delivery to the Independence Blue Cross client. Acts as outward-facing, dedicated resource. Builds relationships with employer/group clients (not individual members) and serves as the primary point of contact for overall and day-today service delivery.

This role will represent the client internally and coordinates with other functions to implement products, complete projects, and address ongoing service needs.

If you are located in Philadelphia, South Jersey, or Delaware, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Manages ongoing contract relationships and service delivery to clients for large complex government segment
  • Government segment accountable for the clients' overall service experience and operational support measured on client retention, NPS and service support for upsells
  • Acts as outward-facing, dedicated resource for assigned accounts, typically with direct client contact (not call center) and large or complex accounts
  • Represents client internally and coordinates with other functions to implement client systems, complete projects, and address ongoing service needs
  • Travels to client site to provide consultative services and recommendations
  • Analyzes reports to determine client trends, recommendations, and implements programs appropriate for the client
  • Identify trends, document lessons learned, and drive continuous service and client process improvement
  • Represent OptumRx on client calls and visits
  • Oversee all PBM operational functions pertaining to day-to-day management of the client
  • Works with other departments to develop operational solutions and recommendations
  • Participate in on-site and telephonic, general client meetings including service-related, open enrollment, and executive performance reporting meetings, as required
  • All business performance management activities related to client service operations
  • Operate as a liaison between our Contract Management Department and Client's Auctorial Team
  • Provide oversight and management of the Client's Performance Guarantee Process
  • Provides expert advice and analysis of proposed Federal and State legislation that may impact the pharmacy benefit
  • Maintains consistent and regular client communications
  • Maintains a complete understanding of client contract terms including the reporting of performance guarantees and managing service improvements. Ensures that all assigned contracts are monitored and reported as stated in the terms
  • Manages and mentors account management team members. Specific topics may include the creation and delivery of client presentations, upsell techniques, implementation activities and daily client interaction. Provides staff with feedback at least quarterly on the level of accomplishment of personal and departmental goals. Develops strategies for staff development and retention
  • Provides regular feedback to management team regarding client metrics, client requirements and business development opportunities
  • Regularly attends and actively participates in company meetings as requested
  • Exhibits compliant and ethical behavior in the performance of job responsibilities, including complying with all applicable federal and state laws and regulations, OptumRx Code of Conduct, Business Ethics Policies and Procedures and other policies and procedures applicable to position
  • Performs other duties as assigned to meet corporate objectives

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:

  • Bachelor's Degree or Higher or relevant work experience
  • 4+ years of PBM experience
  • 4+ years of client management experience
  • 4+ years of direct client facing roles
  • Successful in client escalation resolution
  • Ability to interpret data and successfully manage from data

Preferred Qualifications:

  • Experience with Rx Claims
  • Project Management experience
  • Experience with continuous improvement processes
  • Client Risk Management Planning

UnitedHealth Group is working to create the health care system of tomorrow.

Already Fortune 5, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.

Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.

Careers with OptumRx. We're one of the largest and most innovative pharmacy benefits managers in the US, serving more than 12 million people nationwide. Here you'll fill far more than prescriptions. As a member of one of our pharmacy teams, you're empowered to be your best and do whatever it takes to help each customer. You'll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. There's no better place to help people live healthier lives while doing your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy

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: Sr. MEDD Operations, Manger, Health Plans, Government Segment, Philadelphia, PA, Pennsylvania, South Jersey, DE, Delaware, Work from Home

Wilmington, Delaware UnitedHealth Group

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

The Sr. Operations Manager, Heath Plans will serve as the manager for ongoing contract relationships and service delivery to the Independence Blue Cross client. Acts as outward-facing, dedicated resource. Builds relationships with employer/group clients (not individual members) and serves as the primary point of contact for overall and day-today service delivery.

This role will represent the client internally and coordinates with other functions to implement products, complete projects, and address ongoing service needs.

If you are located in Philadelphia, South Jersey, or Delaware, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Manages ongoing contract relationships and service delivery to clients for large complex government segment
  • Government segment accountable for the clients' overall service experience and operational support measured on client retention, NPS and service support for upsells
  • Acts as outward-facing, dedicated resource for assigned accounts, typically with direct client contact (not call center) and large or complex accounts
  • Represents client internally and coordinates with other functions to implement client systems, complete projects, and address ongoing service needs
  • Travels to client site to provide consultative services and recommendations
  • Analyzes reports to determine client trends, recommendations, and implements programs appropriate for the client
  • Identify trends, document lessons learned, and drive continuous service and client process improvement
  • Represent OptumRx on client calls and visits
  • Oversee all PBM operational functions pertaining to day-to-day management of the client
  • Works with other departments to develop operational solutions and recommendations
  • Participate in on-site and telephonic, general client meetings including service-related, open enrollment, and executive performance reporting meetings, as required
  • All business performance management activities related to client service operations
  • Operate as a liaison between our Contract Management Department and Client's Auctorial Team
  • Provide oversight and management of the Client's Performance Guarantee Process
  • Provides expert advice and analysis of proposed Federal and State legislation that may impact the pharmacy benefit
  • Maintains consistent and regular client communications
  • Maintains a complete understanding of client contract terms including the reporting of performance guarantees and managing service improvements. Ensures that all assigned contracts are monitored and reported as stated in the terms
  • Manages and mentors account management team members. Specific topics may include the creation and delivery of client presentations, upsell techniques, implementation activities and daily client interaction. Provides staff with feedback at least quarterly on the level of accomplishment of personal and departmental goals. Develops strategies for staff development and retention
  • Provides regular feedback to management team regarding client metrics, client requirements and business development opportunities
  • Regularly attends and actively participates in company meetings as requested
  • Exhibits compliant and ethical behavior in the performance of job responsibilities, including complying with all applicable federal and state laws and regulations, OptumRx Code of Conduct, Business Ethics Policies and Procedures and other policies and procedures applicable to position
  • Performs other duties as assigned to meet corporate objectives

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:

  • Bachelor's Degree or Higher or relevant work experience
  • 4+ years of PBM experience
  • 4+ years of client management experience
  • 4+ years of direct client facing roles
  • Successful in client escalation resolution
  • Ability to interpret data and successfully manage from data

Preferred Qualifications:

  • Experience with Rx Claims
  • Project Management experience
  • Experience with continuous improvement processes
  • Client Risk Management Planning

UnitedHealth Group is working to create the health care system of tomorrow.

Already Fortune 5, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.

Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.

Careers with OptumRx. We're one of the largest and most innovative pharmacy benefits managers in the US, serving more than 12 million people nationwide. Here you'll fill far more than prescriptions. As a member of one of our pharmacy teams, you're empowered to be your best and do whatever it takes to help each customer. You'll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. There's no better place to help people live healthier lives while doing your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy

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: Sr. MEDD Operations, Manger, Health Plans, Government Segment, Philadelphia, PA, Pennsylvania, South Jersey, DE, Delaware, Work from Home