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The Associate Director Quality Field team position will provide leadership to a team of Practice Performance Managers in Arkansas and Alabama and is accountable for the performance and direction of Stars Quality and Risk performance for provider practices in designated H contracts (health plans and markets) as well as other incentive initiatives.
This position will work with the Quality Field Managers and team to drive Stars and Risk strategy through provider engagement of key health systems and provider groups to help transform their practices to better manage the health and quality of their UHC Medicare populations including HEDIS / Stars performance in incentive or risk programs. This includes relationship building, assessments of current capabilities and process gaps, analyzing performance reporting, driving incentive engagement, and Quality action plan development including CAHPS and HOS. They will lead and participate jointly with their team in meetings with providers to find new ways to collaborate; ensuring that our collective approach is patient and provider centered.
Will require a highly organized approach to a heavy workload with frequent requirements to re-prioritize. Internally, this role will drive the operations for a team of Field based employees working with Providers and manage their work and progress against individual, market and national goals.
The role will work through multiple layers of management and senior level professional staff, and impacts the entire health plan performance. The position will lead the organization - across all matrix partners and across multiple layers of management and senior staff, with a focus on quality, risk, member engagement, provider relationships, clinical care coordination and data / reporting - to develop the strategy, programs and tactics necessary to achieve Healthplan quality and risk outcomes on a sustainable basis.
Development and execution of clinical and quality strategy related HEDIS, Part D Stars and risk Improvements in partnership with Medicare Market CEO, Executive Director, Data Support, and other Optum and UHC parties as appropriate
Day to day leadership of the market's Medicare Stars & risk results
Participation and leadership in provider meetings focused on HEDIS and Part D quality improvement, in partnership with Healthcare Advocates, UHC's network management team, Practice Based Support and local Medicare leadership
Cross functional leadership and engagement with health plan, clinical accountable care teams, and operations
Regular reporting and updates to senior leadership, including Health Plan CEO and segment clinical and quality teams. Development of PowerPoint and data packages.
Leadership and support of achieving a minimum of 4 Star rating for assigned H contracts and for achieving 80% of our members in 4 Star or better plans and risk suspect coding assessment and diagnosis @75%
Direct management of Quality Field team engaging with Provider offices and accountable for member outreach goals
Participation in health plan senior leadership team
Will manage staff and programs in a complex, growing and evolving organization
Provide leadership to multiple direct reports (Manager level) and accountability for approximately 35 indirect reports and is responsible for performance of managers and staff
Manage and ensure metrics and performance goals are met and regularly report to leadership
Recommends and participates in departmental policy and procedure development and ensures that policies and procedures are enforced to ensure compliance with all contractual and regulatory requirements
Will utilize business and financial acumen as well as the ability to interpret and apply data in directing and prioritizing work
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.
Bachelor's degree in Healthcare, Health Administration, Communications, Science, Business Administration or Finance (or equivalent education and experience)
3+ years of leadership experience (Manager or Director level) with staff oversight and a proven track record of exemplary leadership experience in the managed health care industry
1+ year front facing provider experience
1+ year direct input/involvement in business strategy planning and development
2+ years of HEDIS, Stars and Risk Adjustment experience
Advanced technical skills for Microsoft Word, Excel, PowerPoint, Outlook, Adobe and Access
Proven record of strong analytic thinking capabilities
Arkansas or Alabama physical location
Daily travel 40-50% within Markets
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 similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
Demonstrated success, with a deep understanding of Health Care delivery operations and compliance, health care financing and industry trends
Strong negotiation skills; the ability to gain acceptance from others of a plan or idea and to achieve mutually beneficial outcomes
Strategic thinking capabilities
Strong knowledge of electronic medical record systems
Strong knowledge of the Medicare market
Strong relationship building skills with clinical and non-clinical personnel
Knowledge base of clinical standards of care, preventive health, and Stars measures
Strong problem-solving skills
Experience in managed care working with network and provider relations/contracting
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)
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: HEDIS, Stars, Risk Adjustment, Manager, Director, Travel, Healthcare, Medicare, Associate Director, Quality, Alabama, Arkansas, AL, AR