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UnitedHealth Group Clinical Performance, Market Relations Regional Program Manager - 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 Associate Director. This position is responsible for end-to-end business process and clinical program activities, which includes creating, controlling and improving processes and program performance. This may oversee work activities of other supervisors and is often working to adapt plans and priorities to address CDOs opportunities and challenges. Role provides primary support to CDOs on the lower end of Complexity / Demand / Size (new to risk, small membership, very self-sufficient and “low touch”, etc.) or acts as secondary for CDOs on the higher end.

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

Primary Responsibilities:

  • Primary support for Regional Associate Directors to ensure management of critical programs with proven value to Care Delivery Organizations (“CDO”) across Risk Adjustment, Quality and Affordability

  • Clinical Performance liaison to local Care Delivery Organizations (CDO) with accountability on a portfolio of initiatives driving clinical and operational performance

  • Role provides primary support to CDOs on the lower end of Complexity/Demand/Size (new to risk, small membership, very self-sufficient and “low touch”, etc.) or acts as secondary for CDOs on the higher end.

  • Effective management of project plan timelines, deliverables, communication and performance to CDO program targets and goals

  • Facilitation of meetings to drive execution of initiatives

  • Assisting in the development of program needs and goals as related to Optum’s Quadruple Aim

  • May oversee work activities of other supervisors

  • Strong problem solver who can quickly reference continuous improvement tools

  • Ensure prompt escalation of challenges/issues that will impact the business and initiative delivery

  • Operational Project and Program management supporting and driving the implementation on both the individual Care Delivery Organization, Regional, and broader Care Delivery levels

  • Partner with internal Clinical Performance team to provide tools and materials for Care Delivery Organizations

  • Collaborate with peers to maintain Care Delivery knowledge across the team

Critical Success Factors:

  • Self-starter and be able to take direction and come up with approaches and solutions

  • Excellent multi-tasking skills

  • 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 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 in all markets

  • 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.

Required Qualifications:

  • Bachelor’s degree

  • 5+ years of solid Project Management experience and successful project delivery

  • 5+ years of combined experience within managed care / health insurance industry experience in government relations, network management, and/or legal / compliance

  • Experience in successfully delivering on Operational projects in a matrix environment

  • Ability to work independently and in a team environment to deliver on Clinical Risk and Quality initiatives

  • Ability to influence and work with internal and external stakeholders/resources to move projects and programs forward and overcome any challenges

  • Strong personality with a keen sense of ownership and accountability and a “can do” attitude

  • Ability to manage to timelines and escalate issues as appropriate

  • Ability to simultaneously work on multiple projects and help manage project resources

  • Experience documenting, including project planning

  • Comfortable with report outs and presentation to management

  • Good communication skills both written and verbal

  • Good organization and comprehension capabilities

  • Organized and detail oriented

  • Ability to travel up to 50% of the time

  • You will be required to adhere to UnitedHealth Group’s US Telecommuting Policy

  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained

Preferred Qualifications:

  • Familiarity with government pay for performance programs

  • Experience in Medicare risk adjustment

  • Well-honed communication skills (both written and verbal)

  • Ability to build strong relationships across a variety of stakeholders

  • Proficiency with Microsoft Office

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)

*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, Travel, Telecommute, Remote, Work from Home

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