Create a Job Alert.

Enter your email below to save this search and receive job recommendations for similar positions.
Thank you. We'll send jobs matching these to
You already suscribed to this job alert.
US
0 suggestions are available, use up and down arrow to navigate them
What job do you want?

Director, Contract Stars Performance Improvement - Telecommute job in Atlanta at UnitedHealth Group

Create Job Alert.

Get similar jobs sent to your email

List of Jobs

Apply to this job.
Think you're the perfect candidate?
Director, Contract Stars Performance Improvement - Telecommute at UnitedHealth Group

Director, Contract Stars Performance Improvement - Telecommute

UnitedHealth Group Work From Home, GA Full Time

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve 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 Director, Contract Stars Performance Improvement 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 United States as you take on some tough challenges.

Primary Responsibilities:

  • Provides leadership and support in establishing and directing the Stars Program for specific contracts
  • Develops and maintains policies and procedures that support the corporate initiatives that meet State, Federal legal requirements and standards
  • Collaborates with physicians to execute the implementation of the Star initiatives as defined by enterprise and/ Optum LCDO
  • Provides expertise to the training department on Star measures and tools that support collection of and communication about HEDIS/STAR to the enterprise
  • Develops HEDIS/STAR member and provider engagement strategies
  • Collaborates with WellMed executive team to execute HEDIS/STAR strategies
  • Works with Optum LCDO Quality leadership team to provide HEDIS/STAR reporting and to develop strategic direction
  • 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
  • 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
  • Oversees the CAHPS/HOS survey process for all contracted health plans
  • 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 
  • 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
  • Directs medical/nursing/clinical best practice identification and standardization adoption in clinical settings with cross-functional teams and senior leaders
  • Directs and promotes 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.

Required Qualifications: 

  • BA/BS degree in healthcare related field; clinical background (Registered Nurse or Nurse Practitioner)
  • 6+ years of management-level experience in managed care Quality programs, including 5+ years of experience at the Director level or above
  • Demonstrate knowledge of the business environment and business requirements (e.g., strategy changes, emerging business needs) 
  • Knowledge of CAHPS, HOS, NCQA HEDIS requirements and CMS STAR requirements 
  • Knowledge of fiscal management and human resource management techniques
  • Ability and willingness to travel both locally and non-locally as determined by business need

Preferred Qualifications:

  • Ability to establish and maintain effective working relationships with employees, managers, healthcare professionals, physicians and other members of senior administration and the general public
  • Excellent verbal, written communication, presentation, and facilitation skills

Physical and Mental Requirements: 

  • Ability to lift up to 25 pounds 
  • Ability to sit for extended periods of time 
  • Ability to use fine motor skills to operate office equipment and/or machinery 
  • Ability to receive and comprehend instructions verbally and/or in writing 
  • Ability to use logical reasoning for simple and complex problem solving

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

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 550,000+ 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)

WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.

Colorado Residents Only: The salary range for Colorado residents is $94,500 to $171,700. 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.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Director, Contract Stars Performance Improvement, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote

 

Recommended Skills

  • Performance Improvement
  • Quality Management
  • Business Process Improvement
  • Operations
  • Registered Nurse Certified
  • Managed Care
Apply to this job.
Think you're the perfect candidate?

Help us improve CareerBuilder by providing feedback about this job:

Job ID: 2014148

CareerBuilder TIP

For your privacy and protection, when applying to a job online, never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction. Learn more.

By applying to a job using CareerBuilder you are agreeing to comply with and be subject to the CareerBuilder Terms and Conditions for use of our website. To use our website, you must agree with the Terms and Conditions and both meet and comply with their provisions.