At UnitedHealthcare, our focus is on helping people live healthier lives. As we work to better serve all populations, we have identified a need to look beyond the traditional path of member services. myConnections’ mission is to transform the UnitedHealthcare Community & State business by expanding from Medicaid into the balance of government assistance programs for the low income population. Our commitment to innovation has lead us to even more new ideas and an interest in better understanding how we can work in communities to help drive real change.
Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)
The Program Manager - Community Based Organizations is the market lead responsible for collaborating with the State and Operations Director to design and implement successful health plan level pilot program. More specifically, this role is accountable for building a network of Community Based Organization partnerships within the local market to support electronic referrals. This role will be accountable for developing and leading the network strategy and execution and ensuring the needs of the market are met. This also includes onboarding, credentialing and ongoing account management of the network providers. This position will require extensive face to face contact and related travel within a state to build network of community based organization providers.
Additionally, this role will lead local implementation, training and ongoing maintenance of the program technology which facilitates the intake, assessment, provider search and referral of social service needs to the network. This includes both external community based providers, as well as internal users.
Since this is a new program within UnitedHealthcare, this position will require an individual to work in an ambiguous situation, helping to operationalize national strategies to meets the needs of the local market. This position requires an independent and strong leader able to communicate and tell the story of the program to senior leaders within community based organizations. This position also requires a strong understanding of the local market, social service programs, and community based organizations.
- Provide leadership in developing project plan, milestones, and associated structure from pilot strategy and high - level objectives/outcome measures
- Lead the development of new concepts, technologies and products to meet emerging customer and market needs
- Identify and solve problems that impact the management, direction and outcomes of the pilot
- Provide recommendations and data / information to drive informed leadership decisions on pilot strategy and direction
- Collaborate with assigned vendor providing technologies and network administrative services to verify their credentials, service and the accuracy of their network listings
- Lead implementation, training and ongoing maintenance / issue resolution of program technology locally
- Implement the screening and referral process in conjunction with clinical delivery site staff
- Facilitate the screening, referral, and training process at clinical delivery sites
- Work closely with the Quality Improvement Facilitator and Hawaii Accountable Health Communities (AHC) Advisory Board (HAAB) to ensure the network of social services providers reflects the needs of the Medicare and Medicaid beneficiaries
- Document and track screening and referral services (Community Based Organizations)
- Collect and report data as required by the Centers for Medicare & Medicaid Services (CMS) and its contractors
- Maintain the Community Resource Inventory on a biannual basis, updating the listed organizations
- Currently reside in Honolulu and be familiar with the local community
- Undergraduatedegree or equivalent work experience
- 4+ years working with community based organizations in Honolulu
- Proven background in partnering / working with businesses, community groups, law enforcement, faith - based organizations, medical professionals and service providers on treatment and prevention to end domestic violence
- Experience in supporting men, women, and their families in regard to domestic / relationship violence
- Strong knowledge of local community and community based non-profit organizations
- 2+ years in project management or project leadership experience
- Proficiency in MS Office (Excel and PowerPoint)
- Willing and able to locally travel 50% of the time
- Must live within commutable distance of the location listed for this specific career opportunity
- Willing and able to adapt to change in an unstructured environment, by being inspired by innovation
- Leadership experience including leading presentations, communication across a matrix organization or program
- Experience succeeding at working independently in ambiguous situations
- Excellent communication skills, including ability to communicate effectively with various levels of leadership including sr. leadership
- Experience working with a managed care organization, health insurer, or consultant in a network management/contract management role, such as contracting, provider services, etc.
- Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information form others, including but not limited to reimbursement policy standards
- Strong interpersonal skills, establishing rapport and working well with others
- Passion for innovation and solving community challenges
Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)