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Marcus by Goldman Sachs, Delivery Workforce Planning and Hiring Process Manager, Vice President - Richardson, TX
Richardson, Texas, United States · On-site
Senior$32B raised
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Job DetailsJob Location: Work from Home - Richardson, TX 75082Position Type: Full TimeEducation Level: High SchoolSalary Range: $17.25 - $24.00 HourlyTravel Percentage: NoneJob Shift: DayJob Category: Health CareCompany …
Skills: Accounts Receivable, Medical Billing, Insurance Claims Processing, Medical Terminology, CPT Coding
The Director of Clinical Optimization serves as the primary liaison between account management and operations to ensure all customer commitments and clinical targets are met. This role manages a large portfolio of strategic accounts, focusing on operational performance, quality metrics, and the implementation of outcome-based strategies.
Requirements
Candidates must have at least 2 years of experience in managed care clinical operations or account management, including client presentation and stakeholder relationship management. A Registered Nurse license and experience in call center operations are preferred.
Full job description
Optum 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.
The Director of Clinical Optimization (DCO) is a highly visible role which is responsible for ensuring that all customer commitments are met, including clinical-based and operations targets in a fast paced, multi-stakeholder environment. This Director has significant customer interface and acts as the liaison between account management and operations.
You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Single point of contact for UnitedHealth Care Strategic Client Executives and Optum Strategic Account Executives for a portfolio of strategic National and Key Accounts
Role serves as the program director for clients including managing population of over 360K members and 50+ clients with specific focus on partnership with the consultant (Mercer) including intense support, including HCC reviews and onsite strategy meetings
Accountable for the end-to-end operational performance against Customer deliverables within Population Health Service delivery
Manages Customer commitments and expectations jointly with Account Management Team
Ensures scalability and sustainability of Customer specific operational processes delivering against Customer commitments
Drives Customer performance against quality metrics; communicates customer status and remediation action plans
Proactively identifies and mitigates potential service gaps and customer specific quality opportunities ensuring a timely resolution.
Monitors the performance of Optum products to ensure program metrics are meeting internal operating goals
Track and manage to client-specific clinical performance guarantees (CPG) and claims trend guarantees (CTG)
Contribute to client-facing presentations of program performance results in health plan reviews and Customer partnership meetings
Responsible for researching and resolving clinically related member escalations
Participate in Customer specific implementation meetings (internal & external), including client transitions as necessary; conducts post-implementation system audits
Partners with clinical team & leadership to identify, implement and monitor outcome- based strategies tailored to Customer-specific culture and membership
Collaborates with internal and external programs to ensure strong integration with clinical programs and efficient vendor referral processes
Proposes, implements & monitors customer-specific service delivery pilots to address efficiency opportunities and process gaps
Develops and leads execution of continuous improvement initiatives to ensure exceptional member experience and Customer satisfaction
Engage in Customer audit preparation meetings, including initial scope discovery meetings; partners with the Audit Team, Operations and Product to prepare pertinent materials and slides
Manage post Customer audit action plans to completion through accountable owners
Contributes to & participates in High-Cost Claimants reviews if service purchased by customer and Exception is approved with defined parameters
Partner with internal resources across operations, business intelligence and product to enhance cross-program coordination
Responsible for presenting Customer Performance reporting to internal audiences
Works with Product owners and Finance to ensure profitability of the model
Participate in finalist meetings and contribute to renewal RFPs demonstrating expertise and knowledge of their membership
Contributes to and participates in 1) AMT & Partnership meetings, as defined by purchased product, 2) QBRs to provide Customer-specific commentary on remediation plans, 3) external Customer & vendor meetings
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:
2+ years of managed care clinical operations or account management experience
2+ years of customer/client presentation experience
Experience managing client and stakeholder relationships: internal (staff, matrixed resources) and external (client, carrier, consultants & vendor)
Experience in negotiations and gaining consensus across a multidisciplinary team (internal & external partners) to include Clinical Consultants, product, and account management
Program management experience
Experience analyzing and interpreting customer/client data and making recommendations to operations / clients based for improvement based on data
Preferred Qualifications:
Registered Nurse with active RN license
5+ years of Call Center operations experience
3+ years of experience as a Registered Nurse in a clinical setting
Competencies:
Operational End to End thinker: broad program and delivery modality knowledge
Strategic operations leader: able to make decisions and drive execution
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 $112,700 - $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.
UnitedHealth Group is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.
We are 340,000 colleagues in two distinct and complementary businesses working to help build a modern, high-performing health system through improved access, affordability, outcomes and experiences.
Optum delivers care aided by technology and data, empowering people, partners and providers with the guidance and tools they need to achieve better health. UnitedHealthcare offers a full range of health benefits, enabling affordable coverage, simplifying the health care experience and delivering access to high-quality care.
We work with governments, employers, partners and providers to care for 147 million people and share a vision of a value-based system of care that provides compassionate and equitable care.
At UnitedHealth Group, our mission calls us, our values guide us and our diverse culture connects us as we seek to improve care for the consumers we are privileged to serve and their communities.
Click below to search careers or join our social communities:
• Search & apply for careers at careers.unitedhealthgroup.com/
• Follow us on Twitter at twitter.com/UnitedHealthGrp
• Follow and like us on Facebook at facebook.com/unitedhealthgroup
• Follow us on Instagram at instagram.com/unitedhealthgroup
More about UnitedHealth Group can be found at unitedhealthgroup.com/
Offices: Eden Prairie , Minnesota, US · 2716 N Tenaya Way, Las Vegas, NV 89128, US · 4425 E Cotton Center Blvd, Phoenix, AZ 85040, US · 1900 E Golf Rd, Schaumburg, IL 60173, US · 8822 Three Chopt Rd, Henrico, VA 23229, US
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How many Customer Service & Support jobs are open in Richardson, TX right now?
There are currently 554 open customer service & support positions in Richardson, TX listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Customer Service & Support roles in Richardson, TX?
Companies currently hiring include Albertsons Companies, Celestica, Realpage, Allied Universal, Lowe's Companies, Inc., among others. Browse the listings above to see every active employer.
Are there remote or hybrid Customer Service & Support jobs in Richardson, TX?
Yes — 66 of the 554 open customer service & support positions offer remote or hybrid work (19 remote, 47 hybrid).
How do I apply for Customer Service & Support jobs in Richardson, TX?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.