If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm) The Enterprise Clinical Performance Operational Efficiency Team is charged with effectively implementing, monitoring, and executing on clinical documentation and quality programs that promote patient health while improving the provider practice experience with a special focus on Medicare Risk Adjustment and HEDIS. Enterprise Clinical Performance Operational Efficiency Team processes on a national level by providing support in all markets served by OptumCare Delivery. This position will report into the Director of Market Relations and will be responsible for developing relationships and driving implementation of Risk Adjustment & Quality initiatives across new OptumCare Delivery organizations The Regional Associate Director is responsible for managing the Market Relations program operations and providing market-focused support and value to the OptumCare Delivery Organizations. This includes monitoring & providing transparency to results and assisting in issue resolution/escalation. Effective facilitation and communication with leadership, CDQI internal teams, and external business partners is imperative. Primary Responsibilities:Responsible for helping to manage Market Relations program operations for all CDOs Monitoring & providing transparency to results and assisting in issue resolution/escalation. Facilitation/communication with leadership, internal teams, and external business partners with relation to chart review process improvement and keeping tasks organized A Initiatives UM DM CM Palliative Care HEDIS/STAR Gaps in care Best practices for provider engagement Provider incentives Member engagement Embedded clinical model Training programs Compliance programsCritical Success Factors:Working in a matrix environment to drive efficiencies through influence Seeks ways to improve job and operational efficiency and makes suggestions as appropriate Takes ownership of the total process and provides constructive information to minimize problems and increase provider and market satisfaction Partners with Local Care Delivery leadership teams and Optum management across markets to coordinate execution and implementation in all markets Ensure activities are appropriately integrated into the strategic direction, as well as the mission and values of the company
Required Qualifications: Bachelor's degree or greater or equivalent experience 5+ years combined experience within managed care/health insurance industry experience in government relations, network management, and/or legal/compliance 5+ years of previous data analysis, process documentation, and process improvement experience 5+ years of previous experience interacting with business leadership Risk Adjustment experience End-to-end program orchestrator for all components of clinician risk adjustment activity within client/health plan environments related to program strategy and resource needs 50% travel required Well versed in executive reporting, program documentation, physician engagement and interdisciplinary team collaboration Very strong analysis background, including financial (ROI, CBA, break-even, gap analysis)Preferred Qualifications:Familiarity with government pay for performance programs a plus 5+ years of direct provider facing experience 1+ years of previous experience in Program Management Experience in Quality with a working knowledge of HEDIS Familiarity with UM/CM/DM Lead a complex or multifunctional/multi-location team/organization Six Sigma certification and/or exposure Proven experience managing organizational growth and change Well-honed communication skills (both written and verbal) Ability to build strong relationships across a variety of stakeholders Proficiency with Microsoft Office Process mapping (Visio, VSM) Proficient in SPSS data analysisCareers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm) 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. Job Keywords: Director; Consultant; HEDIS; Risk Adjustment; Provider Relations, Minneapolis, MN, Minnesota
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.