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UnitedHealth Group Director of Actuarial Services / Healthcare Economics - Telecommute in Eden Prairie, Minnesota

The Director of Actuarial Services/Healthcare Economics for Optum Behavioral Care (OBC) is responsible for the modeling of projected benefit expense outcomes and will work to define and model innovative payment arrangements with select provider groups. The Director will also support valuation and measurement of value creation initiatives and program changes. In addition, the successful candidate will also coordinate and collaborate across both internal and external teams including but not limited to: Optum, UHC, external payers and community stakeholders. The Director will work in close coordination and provide communication to all key stakeholders to ensure understanding of changes in benefit expenses. The Director brings value to the products Optum services by:

  • Identify and communicate benefit expense trend drivers

  • Partner cross functionally to identify mitigation opportunities

  • Determine impact of changes in benefits, reimbursement rates and clinical programs

  • Optimize provider performance and drive value-based reimbursement

  • Provide information and guidance on retrospective and prospective utilization and cost trends

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Model total cost of care. For populations with mental health and substance use disorders, model total cost of care trends and the impact of interventions on trends over time. Design and measure performance on risk-based payment models with providers.

  • Lead and Develop People. Director is responsible to create an environment oriented to trust, open communication, creative thinking and cohesive team effort.Leader will leverage diversity and inclusion and drive employee engagement.

  • Trend and Spend Management. Ensure coordination with HCE and OBC functional teams to provide ongoing information on the utilization and benefit expense changes for the business. Analyses require a working knowledge and synthesis of several leading indicator and claims based reports as well as benefit and regulatory information that leads to the identification of drivers of adverse trend and or spend.

  • Communication of OBC performance . Communicate benefit expense trends and impacts of various benefit and clinical changes specific to internal and external customers. Facilitate trend reviews at channel & market levels to communicate to stakeholders the status of accounts and progress on strategies. Work with Forecast team to ensure forecast trends align with past and future expectations.

Accountabilities Include:

  • Serves as the utilization and benefit expense expert for OBC performance

  • Serves as a utilization and expense expert for new product development and RFPs

  • Resource to senior leadership

  • Represent Actuarial team in relevant 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:

  • Experience with identifying trend drivers using claims, encounter and membership data

  • 5+ years in health care

  • Bachelor's Degree in Actuarial Science, Math, Economics or a related degree

  • ASA or FSA designation

Preferred Qualifications:

  • Experience with SAS and/or SQL

  • Excellent verbal and written communication skills

Raising our game in actuarial science will help UnitedHealth Group maintain our leadership for years to come. Join us. Learn more about how you can start doing your life's best work.(sm)

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

Already Fortune 6, 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.

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: actuary, value based payment, behavioral health

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