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Performance Director - HEDIS, Stars - Telecommute Pacific Northwest Region job in Atlanta at UnitedHealth Group

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Performance Director - HEDIS, Stars - Telecommute Pacific Northwest Region at UnitedHealth Group

Performance Director - HEDIS, Stars - Telecommute Pacific Northwest Region

UnitedHealth Group Work From Home Full-Time
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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)

This position has responsibilities for Quality Performance Improvement activities for specific contracts across multiple geographies. Serves on multiple Optum Clinical and Quality Committees and leadership teams designed to provide strategic direction for all local care delivery groups within Optum.

The Associate Director of General Management (HEDIS, Stars) provides strategic direction, leadership and oversight for performance. This role is responsible for planning, organizing, and directing the administration of all Quality Programs / Strategies. 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, ensures 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 Pacific Northwest as you take on some tough challenges.

Primary Responsibilities:

  • Participates in requested evaluations and audits related to HEDIS / STAR
  • Collaborates with CDO to ensure successful execution of Star Measure initiatives as defined by enterprise and / Optum
  • Collaborates with OptumCare Quality Performance Executive team on HEDIS / STAR strategies
  • Works with Optum LCDO Quality leadership team to provide HEDIS / STAR reporting and to develop strategic direction
  • Collaborate / contribute to team SharePoint development
  • Facilitates, integrates, and/ or coordinates the implementation and evaluation of identified CAHPS / HOS / quality improvement / HEDIS / STAR activities as requested by UHG / UHC or related companies
    Promotes understanding, communication and coordination of all quality improvement program components
    Coordinates reporting on quality initiatives to all appropriate committees
  • 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
  • Participates in various teams, committees and meetings at any level required to maintain business necessity
  • Plan / develop agenda and cadence for CDO market meetings (Ad hoc market meetings, Onboarding, Quality Alliance Participation)
  • Provides leadership and support in establishing and directing the Stars Program for specific contracts
  • Oversees the CAHPS / HOS survey process for all contracted health plans
  • Oversees 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
  • Develops and maintains policies and procedures that support the corporate initiatives that meet State, Federal legal requirements and standards
  • Maintains Star program documents, reports, and committee minutes and follows all internal privacy and confidentiality policies and procedures
  • Engage and collaborate with Analytics team on creation of Stars / Quality data / reporting to ensure customer requirements and are met
  • Provide strategic direction, leadership and oversight for market performance
  • Develops HEDIS / STAR member and provider engagement strategies
  • Directs medical / nursing / clinical best practice identification and standardization adoption in clinical settings with cross-functional teams and senior leaders
  • Analyze data for trending/patterns to identify improvement opportunities weekly
  • Lead and manage Quality / Stars initiatives from concept & design through post deployment

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:

  • 5+ years of experience working with CMS STAR requirements
  • 2+ years of experience presenting to executive teams and other layers of leadership within an organization
  • Experience working with CAHPS, HOS, NCQA and HEDIS requirements
  • Experience in managed care Quality programs
  • Ability and willingness to travel both locally and non-locally up to 25%
  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained

Preferred Qualifications:

  • Bachelor’s Degree
  • Registered Nurse
  • 6+ years of management-level experience in managed care Quality programs
  • Knowledge of fiscal management and human resource management techniques
  • Demonstrate knowledge of the business environment and business requirements (e.g., strategy changes, emerging business needs)
  • Excellent verbal, written communication, presentation, and facilitation skills
  • 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 resources

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.

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: Performance Director, HEDIS, Stars, Healthcare, Telecommute, Remote, Work from Home, Pacific Northwest


Recommended Skills

Performance Improvement
Quality Management
Business Process Improvement
Managed Care
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