Associate Director of Credentialing Quality – 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. 

You’ve been working your way to this opportunity for some time now. You’ve learned to lead. You’ve build a deep expertise in health care network operations. You’ve set your sights on having more impact in more ways. It’s time to join our leadership team and help UnitedHealth Group meet the challenge of shaping where health care will go. We’re building and maintaining extensive provider networks to serve our customers. Our goal is to attract and secure relationships with the best in every specialty and every community. As a leader on our provider credentialing team, you’ll help us vet and document the competencies of physicians and other providers in our networks. As you do, you’ll discover the resources, backing and opportunities that you’d expect from a Fortune 4 leader.

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

Primary Responsibilities: 

• NCQA and Quality programs that are necessary to achieve long-term vision of a National Credentialing Center of Excellence (CCOE). Position will be a leader over all delegation agreements with payors, main point of contact for all NCQA needs internally and with accrediting body, and will lead team of individuals to complete development of quality program for Optum Health CCOE
• Oversee success of Quality program and hold credentialing operations accountable for maintaining a high quality standard that assists achievement of continued NCQA accreditation and improvement to Provider NPS
• Responsibility for quality program accountability for all internal quality needs and any future payor audits
• Manage the team in conducting audits and provide feedback to reduce errors and improve processes and performance
• Develop functional, market level and/or site strategy, plans, production and/or organizational priorities
• Adapt departmental plans and priorities to address business and operational challenge
• Influence or provide input to forecasting and planning activities
• Develop credentialing policies and procedures and own maintenance and governance

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 with accreditation and regulatory standards, example includes NCQA requirements
• 4+ years of experience working within provider teams in the health care industry
• 4+ years Lean Six Sigma experience
• 3+ years of supervisory experience
• Proficiency with MS Excel & Word
• Demonstrated ability to develop correspondence to facilities and clinicians

Preferred Qualification:

• Black Belt 

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

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, or Washington, D.C. Residents Only: The salary range for this role is $104,700 to $190,400 annually. 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.   

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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. 

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