Director of Client Services - Remote from North or South Carolina

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. The Director of Client Services has the responsibility for overseeing, developing, maintaining and servicing a high quality, and satisfied contracted provider network. Key accountabilities of this position include the overall Quality and Risk Adjustment performance of the contracted network providers, strategic vision and planning, and the maintenance of a CMS adequate network. Additional duties include ensuring information and data is readily available to market staff and providers to enable them to accurately and effectively document and address member illness burden, improve quality of patient care, appropriate opportunities to reduce costs, and continually improve overall performance. The person in this position will have a solid working knowledge of key drivers of healthcare delivery, financials, total cost of care, and quality management. The Director Client Services helps Providers within their assigned book of business operate successfully within OptumCare's healthcare delivery model by providing strategic planning and tools to meet goals and builds an equally solid team to effectuate this goal throughout the contracted network. This position is expected to build and sustain solid working relationships with cross functional departments both within the organization and across other organizations including Optum, UHG, and other Care Delivery Organizations. Groups reporting to this position include a team of Account Managers across the states of South Carolina, North Carolina, and Viriginia. If you are live in North or South Carolina, you will have the flexibility to work remotely* as you take on some tough challenges.

The responsibilities of this position demand a wide range of capabilities including strategic planning and analysis skills, accounting knowledge and understanding of financial statements, understanding of managed care contracts, management breadth to direct and motivate, highly developed communication skills, political savvy, and the ability to develop clear action plans and drive process, given numerous issues with interdependencies Analyzes data from a variety of statistical and financial reports and develops recommendations, strategic plans and action plans to improve identified deficits, barriers, and root cause issues. This position will work closely with key physician groups to develop long-term strategic relationships alongside internal departments or subject matter experts, and others as needed Works throughout organization at all levels to build actionable plans and strategies that will further the mission of the organization, drive high-quality execution while also driving efficiencies, and ultimately deliver better healthcare to members Ensures Providers have in depth understanding of the Optum Care Model to include, but not limited to, contractual obligations, program incentives, patient care best practices, quality/HEDIS STAR, risk adjustment, growth, and total cost of care in an effort towards business goals and targets Develops and maintains positive provider relationships and responsible for interpreting and explaining issues related to contracting and reimbursement. Assists internal and external customers with difficult servicing issues and researches or resolves highly complex or escalated concerns related to credentialing, claims, eligibility, utilization management, quality, and risk adjustment programs. Continuously strives to ensure that favorable relationships are maintained while ensuring the interest of the organization Drives change and innovation through continually seeking and implementing value added solutions for clients while working cross-functionally with various departments Communicate and advocate providers' needs to