Associate Director, Quality Field Operations

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

 

This Director level is accountable for achieving assigned targets for Medicare Advantage providers in their assigned Market(s). The Director is responsible for developing and deploying business plans at the market level with a solid focus on managing CMS Risk Adjustment, Clinical Quality, HEDIS and Stars initiatives and building relationships across Market(s) to develop and optimize business opportunities and brand strength. Serving as the local Market expert, work with central function leads to target local strategies that will result in optimal Market(s) effectiveness.

 

You’ll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

 

Primary Responsibilities:

• Ensure targets are met or exceeded for assigned Market(s)
• Development and execution of clinical, RAF and quality strategy related HEDIS and Part D Stars Improvements in partnership with Medicare Market CEO, Executive Director, Data Support, and other Optum and UHC parties as appropriate
• Regular reporting and updates to senior leadership, including Health Plan CEO, CMO, and market leads, this requires development of PowerPoint and Excel 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
• Solid focus on employee development and employee experience
• Monitor Market level trends, risk and opportunities to continually evaluate ability to achieve established targets
• Create provider targets for direct reports and assist in territory management penetration
• Actively participate in the development and execution of site Coding Accuracy, HEDIS,  (prospective and retrospective), Patient Experience and Stars strategic/business plans
• Influence the development and improvement of operations/service processes
• Drive the development and implementation of short-and-long range plans
• Continually assess market competitiveness, opportunities, and risks
• Drive initiatives to optimize Medicare Advantage payment and reimbursement strategy and capabilities
• Build and maintain collaborative relationships with Corporate, Business units within UHG and other Medicare Advantage Plans, Provider relations/Network Development, Marketing and Sales, Clinical Operations, Senior Director leadership in each market
• The Director will be accountable to ensure direct reports that oversee the field staff are performing at a high standard of performance
• Be the primary go to person for all Risk/STARS related activities within their assigned market(s) working within a matrix relationship which includes Network, Market Leads, Health Plan Medical Directors, and other Health Plan and Optum team members to assure that all STARS activities are planned and executed
• Weekly commitment of 50% travel for business meetings (including client/health plan partners and provider meetings) and 50% remote 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.

Required Qualifications:

• 5+ years of experience in a high impact role as a leader in the managed health care industry
• 5+ years of Medicare Stars experience and HEDIS experience
• Experience in the development and execution of Coding Accuracy, HEDIS (prospective and retrospective), Patient Experience and Stars strategic/business plans
• Experience developing and improving operations / service processes including short and long range plans
• Demonstrated experience on driving initiatives to optimize Medicare Advantage payment and reimbursement strategy and capabilities
• A broad base of experience across management care operations, extensive knowledge of health care industry, provider and insurance industry is required to be successful in this role
• Weekly commitment of 50% travel for business meetings (including client/health plan partners and provider meetings) and 50% remote work

 

Preferred Qualifications:

• Reside in the upper Midwest (Missouri / Nebraska / Iowa / Illinois )

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.

 

 

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.