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Job Information

UnitedHealth Group Director, Contract Stars Performance Improvement - Telecommute in San Antonio, Texas

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)

This position has responsibilities for Quality Performance Improvement activities for specific contracts across multiple geographies. Serves on multiple Optum Clinical and Quality Committees and leadership teams designed to provide strategic direction for all local care delivery groups within Optum. The Director, Contract Stars Performance Improvement provides strategic direction, leadership and oversight for performance. This role is responsible for planning, organizing, and directing the administration of all Quality Programs\Strategies. Provides leadership to and is accountable for the performance and direction through multiple layers of management and senior level professional staff. Responsible for coordinating with appropriate personnel to meet operational program needs, ensures compliance with state/federal health plan requirements, Medicare guidelines, NCQA and health plan requirements. Provides long-term planning and oversight to ensure activities are appropriately integrated into strategic direction and operations, as well as the mission and values of the company

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

Primary Responsibilities:

  • Provides leadership and support in establishing and directing the Stars Program for specific contracts

  • Develops and maintains policies and procedures that support the corporate initiatives that meet State, Federal legal requirements and standards

  • Collaborates with physicians to execute the implementation of the Star initiatives as defined by enterprise and/ Optum LCDO

  • Provides expertise to the training department on Star measures and tools that support collection of and communication about HEDIS/STAR to the enterprise

  • Develops HEDIS/STAR member and provider engagement strategies

  • Collaborates with WellMed executive team to execute HEDIS/STAR strategies

  • Works with Optum LCDO Quality leadership team to provide HEDIS/STAR reporting and to develop strategic direction

  • Facilitates, integrates, and/or coordinates the implementation and evaluation of identified CAHPS/HOS/quality improvement/HEDIS/STAR activities as requested by UHG/UHC or related companies

  • Promotes understanding, communication and coordination of all quality improvement program components

  • Participates in requested evaluations and audits for UHC and other health plans

  • Coordinates reporting on quality initiatives to all appropriate committees

  • Participates in various teams, committees and meetings at any level required to maintain business necessity

  • Maintains Star program documents, reports, and committee minutes and follows all internal privacy and confidentiality policies and procedures

  • Oversees the CAHPS/HOS survey process for all contracted health plans

  • Leads the coordination and completion of projects with cross-functional teams and senior leaders across medical/nursing/clinical functional areas to achieve targeted clinical strategic performance goals

  • Oversees medical/nursing/clinical workflow mapping, performance monitoring, and coaching site visits in clinic settings using process improvement methodologies to identify workflow gaps and establish future-state recommendations

  • Directs medical/nursing/clinical best practice identification and standardization adoption in clinical settings with cross-functional teams and senior leaders

  • Directs and promotes clinical support for clinic staff and nursing roles (RN/LVN Health Coach) with subject matter expertise and resources for population management, nurse advocacy and development opportunities, and nurse coaching/feedback programs

  • Perform all related 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:

  • BA/BS degree in healthcare or related field

  • 6+ years of management-level experience in managed care Quality programs

  • 5+ years of experience at the Director level or above.

  • Demonstrate knowledge of the business environment and business requirements (e.g., strategy changes, emerging business needs)

  • Knowledge of CAHPS, HOS, NCQA HEDIS requirements and CMS STAR requirements

  • Ability to establish and maintain effective working relationships with employees, managers, healthcare professionals, physicians and other members of senior administration and the general public

  • Knowledge of fiscal management and human resource management techniques

  • Ability and willingness to travel both locally and non-locally as determined by business need (25% travel)

Preferred Qualifications:

  • Master’s Degree

  • Clinical background (Registered Nurse or Nurse Practitioner)

  • Excellent verbal, written communication, presentation, and facilitation skills

Careers with Optum . Here's the idea. We built an entire organization around one giant objective; make health care 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)

Colorado Residents Only: The salary range for Colorado residents is $94,500 to $171,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

For more information on our Internal Job Posting Policy, click here (https://hub.uhg.com/policies/human-capital/hiring-employment/Internal-Job-Posting/208) .

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, Contract Stars Performance Improvement, CAHPS, HOS, NCQA HEDIS, CMS STAR, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote