Quality Management Consultant - M3P

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Quality Management Consultant (M3P) will support the Medicare Prescription Payment Program (M3P) Quality Management function. As part of this new program team, be part of an accountable strategic effort to ensure critical performance measures are available to internal business functions and external clients/health plans. Additionally, contribute to the regulatory requirements and audit activities through thoughtful evaluation of performance guarantees and service level agreements. Lead related root cause and remediation activities, in conjunction with business partners, and coordinate improvement opportunities within the billing, payment, and ledgering operations, along with additional teams supporting systems driving the end-to-end business process.  Ideal candidates have prior experience evaluating business processes, contractual language, and guarantees - specifically with an understanding how to measure process effectiveness. The ability to coordinate and/or build appropriate and meaningful dashboards is essential to success in this role. 

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:

• Primary duties
  • Build/Maintain process and data flow documentation, document handoffs between data storage and applications
    • Partner with program teams to translate process steps into visual process and data flows
  • Act as primary facilitators for program business processes (Run of Show)
    • Day-of facilitators for member and client impacting process workflows
    • Ensure data and narratives are complete and timely
    • Escalate issues to appropriate leaders for root cause/resolution  
    • Prepare and report out end of cycle performance measures
  • Consult with key stakeholders to identify gaps in processes and data flows, seeking to build reportable measurement systems
    • Collaborate on best practice methods focused on prevention versus detection
    • Recommend performance targets
    • Coordinate data collection processes
  • Build/Maintain Quality and Performance Dashboards 
    • Be a storyteller, create a structure for meaningful dashboards to depict performance over time 
    • Ensure functional teams are capable to report out results for selected program controls
    • Identify opportunities to mature manual dashboards and controls in favor of self-serve, automated results
  • Improve overall program quality
    • Identify quality opportunities and improvements across all impacted applications and products
    • Contribute to the preparation of report outs with key internal business functions
    • Collaborate with internal teams to prepare for and execute internal process and external program audits
    • Use and promote internally-developed execution models, following the guidelines and best practices set by program leadership
    • Maintain program tracking tools and act as Administrators on key SharePoint sites

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 leading Quality-related continuous improvement activities with key internal business functions
• 3+ years of experience building and managing Quality/Performance dashboards, setting measurements/control plans and trend reporting
• 3+ years of experience facilitating development of escalation planning 
• 3+ years of experience leading Rapid Root Cause Analysis (RCA) and remediation actions 
• Experience developing and measuring Performance Guarantees & Service Level Agreements 
• Experience using Power BI data visualization tools; intermediate skills with the ability to consult on report layouts
• Intermediate to Advanced Excel skills with the ability to collect and chart data 
• Intermediate to Advanced PowerPoint skills and experience developing and delivering formal presentations 

Preferred Qualifications:

• Project management experience
• Medicare experience
• SharePoint List development experience
• Experience using Copilot
• Intermediate Miro skills  

*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 $91,700 to $163,700 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.