29 days old

VP, Quality Performance Management - Telecommute in Pacific Northwest Region - 925956

Seattle, WA 98104 Work Remotely
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  • Job Code
    925956

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

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The Vice President, Quality and Stars Performance works within OptumCare Services to drive and execute comprehensive strategies related to CMS Star Ratings. This individual is accountable for the overall Stars performance across all Care Services products. They will lead a cross-functional team with includes the Stars Clinical Strategy and Data and Analytics teams. This role will collaborate and partner with multiple stakeholders across the enterprise. The VP role works with the collective team to develop, maintain, own and execute strategies to improve overall Stars performance.

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If you are located in California, Oregon OR Washington, you will have the flexibility to telecommute* as you take on some tough challenges.

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Primary Responsibilities:

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  • Ownership of overall end to end stars strategy, execution and results
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  • Leads, develops and executes strategies to improve operational efficiencies across Care Serves stars programs
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  • Collaboration with UHC Medicare stars team, regional and local health plan business leaders to improve overall stars ratings for Medicare products
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  • Ensure program compliance and identifies opportunities to improve service and quality outcomes
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  • Oversees the development and execution of stars/HEDIS program management policies, procedures, and guidelines; assists in developing clinical management guidelines
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  • Monitor and evaluate all initiatives, track progress and adjust strategy to achieve organizational goals
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  • Act as a Care Services stars expert for both internal and external stakeholders
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  • Supports quality developing and operationalizing both national and market specific strategies to ensure stars success
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  • Drives Stars data and reporting solutions to measure ongoing performance
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  • Directs the prioritization of activities that ensure we achieve our overall Stars and quality objectives
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  • Presents stars results and ongoing performance measures to senior management
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  • Monitor historical and current data trends in order to make recommendations and predictions
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  • Lead the organization to drive innovative initiatives that address low performing measures
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  • Develop comprehensive, provider-specific plans to increase their HEDIS performance and improve their outcomes
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  • Drives continuous improvement through a holistic and well-run inspection/remediation process, and delivery
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  • Remain current and provide expertise around CMS Star measures, CHAPS, HOS guidelines
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  • Educate, advocacy and influence regulatory and policy organizations on behalf of Care Services
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Youll 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.

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Required Qualifications:

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  • 10+ years of healthcare experience
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  • 6+ years of management experience inclusive of managing leaders in a healthcare setting
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  • 5+ years of experience working directly within Stars, CMS, NCQA, including closing quality gaps
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  • 2+ years of experience managing/implementing clinical products
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  • Experience with Complex Care Management clinical operations (Institutional or Community programs)
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  • Solid demonstrated working knowledge of Medicare advantage and managed care
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  • Solid capabilities in data analysis and driving to metrics/data driven results
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  • Proven skills interfacing across enterprise with numerous business areas
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  • Willing to travel up to 50% nationally as needed
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  • 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 similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
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Preferred Qualifications:

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  • 4-year degree or higher
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  • Registered Nurse
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  • Nurse Practitioner
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  • Experience managing remote staff
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  • Exceptional communication, presentation and influence skills
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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)

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

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OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCares support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

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Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

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OptumCare is a drugfree workplace. Candidates are required to pass a drug test before beginning employment.

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"Job Keywords: VP, Quality Performance Management, Vice President Quality Performance, Vice President HEDIS, Oregon, Washington, California, Portland, Irvine, Mcchord, OR, CA, WA, Pacific Northwest Region, Work At Home, Remote, Work From Home, Telecommute, Telecommuter, Telecommuting

Posted: 2021-05-15 Expires: 2021-06-14

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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VP, Quality Performance Management - Telecommute in Pacific Northwest Region - 925956

UnitedHealth Group
Seattle, WA 98104

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