Advisory Services, Manager of Quality - Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The role and responsibilities of the Advisory Services, Manager of Quality is responsible to plan, organize, direct, control, and lead the assigned business unit. This position specializes in running the day-to-day operation for optimizing performance needed to achieve continuous improvement. The role has primary client facing responsibilities and performs within a matrixed, stakeholder partnership environment and should excel in driving synergistic strategies that drive end-to-end improvement.

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

Primary Responsibilities:

• To promote our client's mission of helping people live healthier lives and achieve optimum performance in Stars score
• Leads client quality initiative execution activities such as NCQA Health Plan Accreditation and Health Equity Accreditation
• Leads client performance management team
• Coordinates critical components of our client's quality management program in compliance with regulatory requirements and NCQA accreditation standards
• Manager works within highly matrixed relationships to implement and maintain the core infrastructure of quality management program
• Oversees the implementation of plan quality management components within the client's market for affiliates and employed medical groups
• Proactively manages and responds to rapidly changing CMS requirements and environments
• Collaborates across business segments to attain or maintain the plan's compliance with CMS, NCQA, PQA standards and contractual requirements as they apply to the quality management program (HEDIS, Part D/Patient Safety, and Patient Experience)
• Develops and maintains positive relationships with internal and external stakeholders who impact Stars & HEDIS performance including but not limited to health plan partners within the scope of the quality management program
• Commands a comprehensive knowledge of risk arrangements, contracts, member, and provider benefit structure
• Ensures the creation and submission of reports to meet Client and health plan contractual requirements
• Identifies gaps in patient care and conveys to our client's offering recommendations for provider and patient engagement for CMS Star Rating
• Prepares presentation and data for reporting to clients
• Develops strategies for quality improvement opportunities, including Star Measures and HEDIS gap closure and patient experience
• Maintains and develops solid collaborative relationships with internal and external stakeholders who impact Stars score performance, client payors, network providers/affiliates, vendors, and internal health data teams are producing accurate and complete reporting clients require to assure improved CMS quality program performance
• Conducts in-depth analyses to target potential interventions or initiatives to improve health plan members quality of care and experience
• Tracks and reports KPIs and KAIs to achieve improved CMS Star Rating
• Managers others (performance management, guidance, support, assessments, interviews, training)

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:

• 5+ years experience in related field with attention to preventative care within government funded health system programs and populations
• 3+ years supervisory or lead experience in related field
• 3+ years of experience with demonstrated functional knowledge related to regulatory adherence of a quality management program (HEDIS, Part D/Patient Safety, NCQA, Stars, auditing, reporting, committee management)
• Experience making formal presentations in front of committees and work group environments and using virtual technology
• Proficiency in software applications that include, but are not limited to, Microsoft Word, Excel, Outlook, PowerPoint
• Proven solid written and oral communication skills with internal and external partners and employees
• Proven effective project management skills in creating, evaluating, and improving strategies for project execution
• Ability to travel domestically up to 10% when required

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $104,700 to $190,400 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

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.

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