UnitedHealth Group Clinical Performance, Client Management Regional Associate Director- Pacific and/or Mountain Timezone Telecommute in Eden Prairie, Minnesota
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)
Clinical Performance (CP) is charged with effectively implementing, monitoring, and executing on clinical documentation, quality, and affordability programs that promote patient health while improving the provider practice experience with a special focus on Medicare Risk Adjustment and HEDIS. Clinical Performance processes on a national level by providing support in all markets served by OptumCare Delivery.
This position will report into the Market Relations Regional Director and will be responsible for developing relationships and driving implementation of Risk Adjustment, Quality, and Affordability initiatives across 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, ensuring operational execution and assisting in issue resolution/escalation. Effective facilitation and communication with leadership, Clinical Performance internal teams, and market based or external business partners is imperative.
Driving local engagement across all OptumCare Clinical Performance Risk, Quality, and Affordability initiatives within a Care Delivery Organization ("CDO")
Clinical Performance liaison to local "CDO" executive team, which includes providing a holistic picture of CDO CP annual program support, performance, escalations, and risks. Provides updates to senior executives on program operational activity
Assisting in the development of program needs and goals as related to Optum's Quadruple Aim.
Monitoring local performance against targets and enterprise goals, and identifying associated opportunities, through enterprise wide forums such as Optum's annual Design Shop and the "BYY"
Manages day to day operational requirements to ensure internal and market trends are meeting project timelines
Ensures early detection of major risks and interdependencies & escalation as necessary
Incorporating internal and external best practices for targeted increase in metrics, provider / patient engagement and overall success of care deliver partners
Serving as primary point of contact for all CDO Clinical Performance support requests. To do this effectively, the Regional Associate Director must coordinate to pull in SME's and project support as needed, allowing these Clinical Performance teams to support and drive execution at the local level.
SME support and program facilitation includes, but is not limited to:
Risk Adjustment & Risk Transfer
Affordability (med expense, behavioral health, palliative care, digital)
Technology and Business Solutions
Integrated Assessment / Attestation / Point of Care Tool Delivery
Ensure communication between the various stakeholders, business leaders and cross functional teams. Creates dashboards and operational metrics to demonstrate program success
Leads monthly and quarterly Joint Operating Committees across all of Clinical Performance to ensure coordination across lanes, appropriate prioritization, and identification of synergies
Manages activity of cross functional teams to help support reporting capabilities
Facilitating local Care Delivery Organization funding support requests for innovative projects and new pilot programs. This includes drafting of business cases, projecting program return on investment, securing funding, and tracking & monitoring program performance post implementation
Serving as main point of contact for vendor management and Optum's Enterprise Sourcing and Procurement teams. This includes partnering with the local market to identify project scope, select OptumCare preferred vendors, assist in finalizing contractual commitments, and implementation
Responsible for integrated assessment program oversight, process development and strategic roadmap execution, ensuring key metrics and timelines are met
Critical Success Factors:
Understanding of national healthcare environment, with a focus on coding and documentation, quality, and affordability workstreams
Effective program management and execution
Working in a matrix environment to drive efficiencies through influence and relationships
Seeks ways to improve job and operational efficiency and makes suggestions as appropriate
Takes ownership of the total Clinical Performance process and provides constructive information to minimize problems and increase provider and market satisfaction
Partners with Care Delivery leadership teams and Optum management across markets to coordinate execution and implementation
Ensure activities are appropriately integrated into the strategic direction, as well as the mission and values of the company
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.
3+ years of experience in Medicare risk adjustment
5+ years of combined experience within managed care / health insurance industry experience in government relations, network management, and/or legal / compliance
5+ years of experience in Program Management
5+ years of data analysis, process documentation, and process improvement experience
5+ years of experience interacting with business leadership
Up to 50% travel required (up to 3 trips a month)
You will be required to adhereto UnitedHealth Group's US Telecommuting Policy
If you need to enter a worksite for any reason, you will be required to screen for symptoms usingthe ProtectWell mobile app, Interactive Voice Response (i.e., enteringyour symptoms via phone system) or a similar UnitedHealth Group-approvedsymptom screener. Employees must comply with any state and local maskingorders. In addition, when in a UnitedHealth Group building, employees areexpected to wear a mask in areas where physical distancing cannot beattained
Strong familiarity with government pay-for-performance programs and/or consulting background
Client facing role experience in program delivery / program management
Experience in Quality with a working knowledge of Star / HEDIS
Strong knowledge of CMS Risk Adjustment and ICD-10 coding requirements and regulations
Lead a complex or multifunctional / multi-location team / organization
Six Sigma certification and/or exposure
Experience managing organizational growth and change
Well-honed communication & presentation skills (written & verbal)
Strong execution and accountability across multiple projects and programs; independent delivery
Desire and ability to build strong relationships across a variety of stakeholders
Demonstrate visionary thinking and emotional intelligence
Proficiency with Microsoft Office and Excel
Careers at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.(sm)
For more information on our Internal Job Posting Policy, click here at https://hub.uhg.com/policies/human-capital/hiring-employment/Internal-Job-Posting/208 .
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
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: Clinical Performance, Program Management, Medicare Risk Adjustment, Healthcare, Care Delivery Organization, Northeast, Leadership, Travel, Telecommute, Remote, Work from Home
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