Director Stars Performance Improvement (15081097)
Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)
The Director, Contract Stars Performance Improvement - New Markets provides strategic direction, leadership, and oversight for performance for OptumCare care delivery organizations. This role is responsible for oversight of planning, organizing, and directing the administration of Quality Programs/Strategies to maximize Medicare Stars and similar quality rating systems for new markets. Provides leadership to and is accountable for the performance and direction through multiple layers of management and senior-level professional staff. Responsible for coordinating with appropriate personnel to meet operational program needs and ensuring compliance with state/federal health plan requirements, Medicare guidelines, NCQA, and health plan requirements. Provides long-term planning and oversight to ensure activities are appropriately integrated into strategic direction and operations, as well as the mission and values of the company.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
- Collaborate with key business leaders on the roadmap for current digital product portfolio
- Provides leadership and support in establishing and directing the Stars Program for specific contracts for one or more Care Delivery Organizations in a new market
- Collaborates with quality and physician leaders at the national and local market level to plan a winning quality strategy to achieve 4+ Star Ratings performance
- Promotes understanding, communication, and coordination of all quality improvement program components and provider quality tools
- Serves as a Medicare Stars quality expert on performance measures and strategies to improve
- HEDIS, Part D Stars, and CAHPS and HOS quality survey measures
- Participates in requested evaluations and audits for UHC and other health plans
- Coordinates reporting on quality initiatives to all appropriate committees
- Participates in various teams, committees, and meetings at any level required to maintain business necessity
- Maintains Star program documents, reports, and committee minutes and follows all internal privacy and confidentiality policies and procedures
- Leads the coordination and completion of projects with cross-functional teams and senior leaders across medical/nursing/clinical functional areas to achieve targeted clinical strategic performance goals
- May support medical/nursing/clinical workflow mapping, performance monitoring, and coaching site visits in clinic settings using process improvement methodologies to identify workflow gaps and establish future-state recommendations
- May support medical/nursing/clinical best practice identification and standardization adoption in clinical settings with cross-functional teams and senior leaders
- May help promote clinical support for clinic staff and nursing roles (RN/LVN Health Coach) with subject matter expertise and resources for population management, nurse advocacy and development opportunities, and nurse coaching/feedback programs
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.
- 5+ years of experience working with CMS STAR quality programs
- 2+ years of experience presenting to executive teams and other levels of leadership within an organization
- 3+ years acting in a leader/facilitator role to drive implementation of a project or to drive a group to meet a specific goal. These types of roles would be things like HEDIS regional lead or Stars quality leader or Director, Quality, State/Region/National.
- Experience working with CAHPS, HOS, Medicare Stars, and HEDIS requirements
- Experience in managed care quality programs
- Ability and willingness to travel up to 25%, both locally and non-locally
- Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance
- Bachelor’s Degree
- 6+ years of management-level experience in managed care quality programs
- Demonstrate knowledge of the business environment and business requirements (e.g., strategy changes, emerging business needs, etc.)
- Experience establishing and maintaining effective working relationships with employees, managers, healthcare professionals, physicians, and other members of senior administration and the general public
- Experience setting the strategy and developing policies, procedures, and resource
- Excellent verbal, written communication, presentation, and facilitation skills
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado/Connecticut/Nevada residents is $97,300 to $176,900. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
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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.