Manager, Quality Incentive Programs – National Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

 

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 Sr. Program Manager, 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 work remotely * from anywhere within the U.S. 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
• 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 various payer partners or related companies
• Promotes understanding, communication and coordination of all quality improvement program components
• Maintains Star program documents, reports, and committee minutes and follows all internal privacy and confidentiality policies and procedures
• 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
• All other duties as assigned

 

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 related experience in managed care and network development
• Demonstrate knowledge of the business environment and business requirements (e.g., strategy changes, emerging business needs)
• Demonstrated successful relationship management experience with ability to interact one-on-one and consult with all levels of executive management
• Knowledge of CAHPS, HOS, NCQA HEDIS requirements and CMS STAR requirements
• Solid working knowledge of Medicare health care operations and delegation
• Proficiency with Microsoft Office applications to include Word, Excel, Visio, PowerPoint and Outlook.  Working knowledge of Share Point
• Excellent verbal, written communication, presentation, and facilitation skills
• Proven ability to establish and maintain effective working relationships with employees, managers, healthcare professionals, physicians and other members of senior administration and the general public
• Proven ability to successfully conceptualize an initiative, develop a plan and execute the plan through implementation
• Willing to travel for work-related purposes as deemed necessary

  

Preferred Qualifications:

• Project Management experience
• Health plan, healthcare or clinic operations experience
• Experience working in Medicare or Stars Improvement

Physical & Mental Requirements:

• Moves/transports/positions items weighing up to 10 pounds and using up to 25 pounds of force
• Remains in a stationary position for extended periods of time
• Uses fine motor skills to operate office equipment/machinery
• Communicates regularly with others; must be able to exchange accurate information and receive instructions
• Uses logical reasoning for simple and complex problem solving

 

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

 

The salary range for this role is $106,800 to $194,200 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.

 

 

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.

#RPO