Director, Primary Care Regional Operations Optum MA

Opportunities with Reliant Medical Group, part of the Optum family of businesses. Join a community-based, multi-specialty, physician-led organization where you will work with talented peers on a common purpose: improving the quality, cost and experience of health care. Here, we focus on delivering the best patient care, rather than volume. Through innovation and superior care management, we support patients and your well-being as a team member. Join a team at the forefront of value-based care and discover the meaning behind Caring. Connecting. Growing together.

The Director, Primary Care Regional Operations for Optum Massachusetts, oversees clinical operations for primary care specialties and site-wide operations within a region or region(s) for Optum Massachusetts. This position is responsible for achieving performance excellence for Primary Care in the areas of quality, cost, patient satisfaction, financial management and employee performance development at assigned sites. This position has Primary Care wide responsibility for operational business functions including the successful tracking of metrics to improve business functions and the implementation of enhanced business practices across the sites. The position oversees the consistent and uniform application of metrics and growth strategies for Primary Care and is accountable for ensuring Primary Care wide goals and objectives are being met. The position has primary leadership responsibility for the analytical and budgetary management for Primary Care. The position seeks out innovative ways in which Primary Care can be efficient and fiscally responsive while ensuring high quality care standards are met and serves as the managerial leader for the business, financial and data analytics for Primary Care.

This position oversees a team of site-based leaders with principal responsibility for safety, communication and community development across service lines and departments within their assigned location.

This position will also have responsibility for assigned Primary Care wide responsibilities. These responsibilities will be determined based upon strategic initiatives, priorities and particular skills of the person in this role.

This position is responsible for teaming with other service line leaders including Chiefs, Nurse Managers and Operations leaders to provide unified direction and consistent communication to practice based staff. This position will work closely with other service lines and organizational departments to ensure that Optum MA practice standards are met.

This role functions with a high degree of independence, under minimal supervision and has authority for independent decision making within the scope of their responsibilities.

Primary Responsibilities:

Functional oversight for analytical and budgetary responsibilities:

• Has cross site budget responsibility including performance and forecasting including developing and implementing cross site budget management policies and practices and managing cross site fiscal year budget development of over $140 M
• Creates statistical modeling and analysis for Primary Care including but not limited to site encounter tracking and site variance reporting. Develops and tracks metrics to ensure that encounters are tracking to budget and to specialty expectations
• Creates cross site and specialty collaborative efforts on practice efficiencies with focus on sharing staffing resources
• Works collaboratively with central resources for scheduling template management and regular audits to ensure accuracy
• Accountable for ensuring provider based expectations for encounters and RVUs are distributed and that variances are addressed on a monthly basis
• Leads efforts related to improving pharmacy capture rates with emphasis on sites with in-house pharmacies. Works closely with Operational Pharmacy leadership on these efforts
•  Provides oversight, reporting and analysis to inform provider recruitment efforts
•  Leads cross site efforts to partner with nursing leadership on strengthening clinical support workforce
• Works closely with analytics and finance team to develop, train and communicate with site leaders on operational and financial dashboards focused on key performance indicators

Financial Management:

• Working within a matrixed reporting structure, accountable for the monitoring and assessment of financial health of Primary Care practices in area of responsibility. Tracks outcomes against standards of performance and established metrics. Identifies areas of improvement and work to be done to meet objectives
• Oversees site budget development plans, including capital projects and requests
• Understands and adheres to all Optum MA financial reporting requirements. Ensures information provided is in the prescribed format with appropriate rationale and documentation
• Partners closely with Finance and Compliance staff for all revenue cycle operations oversight, such as front-end patient payment collections, coding accuracy and enhancement initiatives, denials management, billing compliance management, and related process-improvement work with providers
• May participate on teams .to develop business plans for new and expanded business and services. Supports capital projects, as assigned
• Provides analysis of TME and develops strategies for regional based improvements

Human Resources Management:

• Collaborates with local Human Resources; oversees hiring of new staff; addresses employee relations issues consistent with Optum MA policy; ensures that all Primary Care staff members receive appropriate orientation and training; and ensures that company policies and procedures, state and federal laws, and union guidelines are followed within assigned sites
• Promotes DEI programs, monitors and reviews job performance and oversees fair, equitable and market competitive compensation
• Provides leadership and supervision to direct reports with responsibility for day-to-day operations of the sites and Primary Care specialties
• Creates a positive environment by developing a team that is collaborative, and knowledgeable about organizational and Primary Care goals and business objectives
• Ensures staffing is appropriate based upon budget, staffing ratios and performance metrics
• Tracks priorities for provider recruitment for each site based upon market demand; understands attrition of current work force (both controllable and uncontrollable) and space

Operations Management:

• Ensures Optum MA practice standards are met within the region for safety, security and workers compensation, and that each site is fully compliant with DPH, emergency management and environment of care safety regulations and requirements
• Assumes significant leadership role for the implementation of care improvement initiatives and principles throughout areas of responsibility
• Creates and fosters a positive environment of solid local leadership with the ability to develop quality and cost-effective solutions and programs, accomplish local and organizational goals and meet the needs of patients and the community
• Conducts space needs planning, renovation, moves, etc. for assigned sites, in collaboration with Facilities Management
• Communicates the Service Line strategies, goals and objectives. Sets expectations and standards to achieve these goals and objectives within the practice locations or area of responsibility
• Performs visits to each site at least 1-2 times a quarter
• Creates and maintains systems strengthening efforts especially focused on staff development among site leadership teams
• Acts as resource and effectively partners with corporate departments such as HR, Safety and Security, Real Estate and others
• In collaboration with the VP of Primary Care, ensures Optum MA's mission, corporate strategy and goals are translated into effective operational processes and procedures for all practice sites
• Assures compliance with Optum MA, OSHA, DPH and state and federal regulations
• Ensure level loading of space across all service lines at practice sites

Clinical Program Management and Network Development: 

• Partners with VP of Primary Care to develop collaborative strategies, processes, programs and solutions to address cross-operational objectives for effective patient care for practice sites within designated region and across all practice sites
• Maintains an in-depth knowledge of the changing health care environment and assesses the market's need for clinical services, ensuring the development of programs and services to respond to the market
• Assumes significant leadership role for the implementation of care improvement initiatives and principles throughout areas of responsibility and across Primary Care. Collaborates across practice sites to create and foster a culture of continuous improvement. Participates in efforts to assess workflows and to develop best practices/process improvement. Oversees the streamlining of processes, eliminating non-value-added work and reviews and monitors progress via relevant metrics and the continual refining of work processes to achieve greater efficiencies
• Ensures the Population Health management protocols are understood, implemented, monitored, and reviewed at each practice site within the region
• Supports the development of preferred partnership relationships in region
• Cultivates a positive and inclusive work environment by prioritizing open effective communication that fosters trust-building and active engagement with team members. Recognizes that solid relationships lead to increased productivity, employee satisfaction, and organizational success. Leverages resources from Clinical Affairs, Organizational Development and Learning (OD&L), and HR Operations to support such efforts
• Performs 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:

• 10+ years of healthcare operational and business management experience in progressively responsible roles, including at least 5+ years management level experience with ambulatory operations and/or physician practice management 
• Supervisory experience, over administrative and clinical staff
• Experience in working with a large physician group and practice managing through influence and collaboration
• Proven knowledge of current leadership, management and quality improvement strategies that address the scope of complexity of patient care needs
• Proven knowledge of applicable federal and state laws and regulations related to the health care industry
• Demonstrated experience with developing and analyzing financial reporting. Expertise with financial analytical programs such as Axiom and BUS
• Experience with various physician compensation models beneficial
• Possesses demonstrated advanced business expertise (i.e. Business Plan Development, Budget Development & Analysis)
• Proven excellent verbal and written interpersonal communication skills
• Proven solid leadership, facilitation, coaching and networking skills
• Ability to inspire and motivate teams
• Ability to work collaboratively and ensures collaboration among team members
• Demonstrated decision-making and problem-solving skills
• Demonstrated ability to use analytic thinking to make critical decisions
• Demonstrated success in managing complex initiatives and projects
• Ability to use all electronic tools and applications relevant to the performance of the duties of the position, including but not limited to phone, keyboard, computer and computer applications
• Driver's License and access to reliable transportation

Preferred Qualifications:

• Experience with IM, FM, Pediatrics and BH operations

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 $112,700 to $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

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