Quality Director of Operations – Remote

For those who want to invent the future of health care, here’s your opportunity. We’re going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

The Director of Quality Operations provides strategic and operational leadership to champion Optum Care Network’s (OCN) transformation to a patient-centered model of care, achieving the Quadruple Aim and providing optimal outcomes for patients.  The Director of Quality Operations partners with the OCN team, Optum care delivery organization teams, the regional Quality team, physician leadership and other stakeholders to establish an optimal care delivery system, develop strategies designed to support the mission of OCN and ensure performance at the highest levels on standardized measures of clinical care quality.  Practice transformation incorporates engaged leadership; quality improvement strategies; continuous and team-based relationships; organized, evidence-based care; patient-centered interactions; enhanced access; and care coordination. 

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. 

Primary Responsibilities 

The duties listed below are intended only as illustrations of the various types of work that may be performed.  The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment.

Develops and implements functional, network level and site strategy, plans, and/or initiatives to support Quality and population health priorities.  Responsibilities include:

• Developing functional, network level and site strategy, plans, and/or initiatives to support Quality and population health priorities in the network and owned groups
• Data analysis and operational activities to identify opportunities and drive outcomes in order to improve Quality outcomes focused on delivery of reliable, timely and patient centered model of care, including but not limited to, HEDIS/Pharmacy, patient safety, clinical guidelines, etc. 
• Accountable business owner for coordinating, prioritizing and implementing Quality initiatives and programs for our Value Based patient populations
• Responsible for coordinating with appropriate personnel to meet operational program needs, ensures compliance with state / federal health plan requirements, Medicare guidelines, HEDIS / STARS, CMS and health plan requirements
• Practice transformation incorporates engaged leadership; quality improvement strategies; continuous and team-based relationships; organized, evidence-based care; patient-centered interactions; enhanced access; and care coordination
• Assist in developing a culture of excellence, through benchmarking, communication of best practices, applying and sharing tools and techniques
• Identifies and resolves technical, operational and organizational problems outside own team
• Partnering with and influencing our Provider network/IPA and owned groups including but not limited to participating in orienting and educating physician practitioners in five Star quality and with Quality Consultants in conducting practice assessments to identify opportunities for improvement and practice transformation
• Collaborates with Network Engagement Team, Advanced Analytics, Credentialing, IT, Optum owned leaders and others to identify and implement key processes changes required adherence to best practice standards
• Interfaces with health plans, government and regulatory bodies and pay-for-performance programs
• Partner with local and national clinical pharmacy teams to coordinate and prioritize pharmacy Quality endeavors
• Develop and manage yearly Quality work plan
• Manage day to day Quality program including internal quality teams
• Oversee clinical guideline development for network practices
• Oversees HEDIS data submission process
• Provide staff support for the Quality committee
• Lead quality work streams and manage leaders responsible for these work streams 
• Support strategic growth goals and participate in the assessment of potential participating physician groups

Performs other duties as assigned.

Knowledge, Skills & Abilities: Note that these requirements are representative, but not all-inclusive, of the knowledge, skill and ability required to perform this job

• Passion and commitment to help change the way healthcare is delivered with a track record of developing successful, innovative and sustainable quality programs
• A proven collaborator who has worked with quality improvement initiative to continually improve processes and effectiveness of quality measures
• Expertise in quality improvement and knowledge of national and local quality measurement systems, reporting and the relationship between quality improvement and incentives
• Highly developed interpersonal, leadership, communication, negotiation, organizational, analytic and team building skills
• Strategic comprehension of an evolving industry to include government regulations and competitive intelligence
• Skilled at defining measurable success criteria to track progress towards achievement of quality and clinical integration strategies
• Exercises active listening skill while understanding the needs and perspectives of others
• Ability to establish and maintain effective working relationships with employees, managers, healthcare professionals, physicians and other members of senior administration and the general public

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 leadership experience in healthcare including experience with Quality programs, managed care, population health management, and capitation/risk models of care

Preferred Qualifications:

• Active and unrestricted WA Registered Nurse (RN) license 
• Certified Professional in Healthcare Quality (CPHQ) 

PHYSICAL AND MENTAL DEMANDS: The physical and mental demands described here are representative of those that must be met by employees to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

PHYSICAL DEMANDS:

While performing the duties of this job, employees are regularly required to sit, walk and stand; talk or hear, both in person and by telephone; use hands repetitively to finger, handle, feel or operate standard office equipment; reach with hands and arms; and lift up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision and the ability to adjust focus.

 

MENTAL DEMANDS:

While performing the duties of this job, employees are regularly required to use written and oral communication skills; read and interpret data, information and documents; analyze and solve non-routine and complex office administrative problems; may use math and mathematical reasoning; observe and interpret situations; learn and apply new information or skills; perform highly detailed work on multiple, concurrent tasks; work under intensive deadlines with frequent interruptions; and interact with managers, staff, customers, patients, the public and others encountered in the course of work, some of whom may be dissatisfied or abusive individuals.

 

TYPICAL WORKING CONDITIONS:  The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

 

Typical office conditions and noise level is usually quiet.  Interaction with others is busy, constant and occasionally interruptive.  Work may be demanding at times.  May require ability to work irregular hours.

 

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

CONTACT:  Physicians, Clinic Leadership, staff, outside agencies, public and possibly vendors.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy. 
 
  
The salary range for this role is $124,500 to $239,400 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.

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.

 

 

OptumCare 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.

 

 

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