UnitedHealth Group Sr. Risk Adjustment Enterprise Business Architect - San Antonio, TX in San Antonio, Texas
Business Analyst is a key senior leader in the Risk Adjustment department.
This role focuses on DataRAP as a product / service and the development, road mapping and maintenance of said product, and related enterprise business capabilities, to drive performance across OptumCare for entities aligned to the DataRAP (and related) system. This position has responsibilities for the Risk Adjustment process and should be familiar with CMS risk adjustment, information management, attestation production; file consumption and Alternative Submission Method.
This individual should also as have experience with managing technology as a product to ensure both the business and IT are in alignment in how current and future needs will be met in an efficient, sustainable, agile, and adaptable manner.
S/he should have deep experience in a matrixed organization and is expected to work closely with the Optum Clinical Performance (CP) teams, WellMed teams (including IT), and other clinical business teams across the enterprise in aligning the strategic development of DataRAP with the business direction for all local care delivery groups within Optum.
Meeting business needs through an architecture that supports the most efficient and secure IT environment needs to come first and be at the center of everything we do - this position is responsible for operating across organizational and computing “silos” to drive common approaches and expose information assets and processes across the enterprise.
At the strategic level, the Risk Adjustment Architect supplements the vision with target capabilities, supporting principles and policies and a current state environmental assessment to provide contextual rationale. Primary Responsibilities: Strategic responsibility for the Risk Adjustment IT applications portfolio which includes but is not limited to Atlas, DataRAP, and ePRG.
Ensure Risk Adjustment systems can optimally scale for future growth needs in excess of 2.5M users in 2019’ 5M users in 2020 and beyond Develop and maintain a strong enterprise 1, 3 and 5 year roadmap of enhancements, and development that meets business leadership needs Maintain awareness of current business and industry issues / trends, and incorporate into enterprise architecture designs as appropriate Promote shared infrastructure and applications to reduce costs and improve information flow.
Ensure that capital projects do not duplicate functionality or diverge from each other; aligns Risk Adjustment business goals to IT strategy and planning Define business plans to drive end-to-end enterprise planning efforts, and prioritize as necessary (e.g., ROI, potential risks, financials) Work with developers or solutions architects to provide a consensus-based enterprise solution that is scalable, adaptable and in synchronization with ever-changing business needs.
Optimize information management through an understanding of evolving business needs and technology capabilities Map capabilities and functionality to internal and external resources and develops business transformation plans jointly with senior business management. Develop required product collateral, in collaboration with applicable business partners (e.g., Clinical, Legal, and Regulatory) Translate strategic initiatives into delivery-focused change initiatives.
Ensure alignment / linkage between business and product plans with product strategies Manage 2-3 direct reports with expectations to grow the team over time.
Professionally develops subordinate staff through effective identification and utilization of internal and external training opportunities.
Conducts annual performance reviews and identifies high potential performers for succession planning purposes Engage through business analysts with capital project(s) with the main purpose of communicating architecture and promoting project alignment Weigh / quantify tradeoffs between business solutions options and available technology options ensuring that proposed solutions meet the business requirements within budget commitments Collaborate with IT to ensure IT teams understand Risk Adjustment business requirements.
Ensure that the defined end-to-end operational business vision (current and future) is properly interpreted, well-understood and clearly documented Review conceptual designs to ensure scalability, applicability, quality and comprehensiveness Contribute to / review SOWs/RFPs and make recommendations for improvement to ensure applicability / comprehensiveness Develop and maintain architectural governance and controls over implementation.
Understand and adhere to the Enterprise Architecture (EA) governance framework (e.g., principles, policies, standards, reference architectures, data-driven designs) Establish status dashboards to drive program/product management processes / reviews (e.g., key metrics, schedules, checkpoints) Develop / manage / oversee project plans to drive implementation of Risk Adjustment programs Direct or indirect involvement in the development of policies, standards and guidelines that direct the selection, development, implementation and use of Information Technology within the enterprise Serve as a leadership champion for the integration of enterprise risk adjustment business initiatives Provide ad hoc consulting in applicable areas of expertise.
Collaborates on a regular basis with the Optum CP team Required Qualifications: Bachelor's degree in Healthcare / Business Administration, Computer Science, Engineering, Economics, or related field or 4 additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a Bachelor’s degree 5+ years of proven track record in leading major organizational strategy and leading multi-market teams in implementing strategy and objectives 3+ years prior operations experience in large, matrix healthcare environment Ability to effectively manage projects, plan and implement programs and evaluate accomplishments Ability to effectively report data, analyze facts and exercise sound judgment when making recommendations to leadership Proficiency with standard Microsoft Office applications Comprehensive knowledge of hardware, software, application, and systems engineering Preferred Qualifications: Master’s degree in Healthcare Administration, Business Administration, IT or a related field Systems thinking - the ability to see how parts interact with the whole (“big picture” thinking) Knowledge of CMS Risk Adjustment for which the enterprise architecture centers around Knowledge of IT governance and operations Knowledge of financial modeling as it pertains to IT investment Interpersonal and leadership skills – servant leadership, collaboration, facilitation, and negotiation skills Careers with WellMed.
Our focus is simple.
We're innovators in preventative health care, striving to change the face of health care for seniors.
We're impacting 240,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services.
We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness.
Our providers and staff are selected for their dedication and focus on preventative, proactive care.
For you, that means one incredible team and a singular opportunity to do your life's best work.(sm) 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. d60d8dfa-20c6-4cb4-9af1-c8ed82d02fdd
Sr. Risk Adjustment Enterprise Business Architect - San Antonio, TX Texas-San Antonio 767728