Associate Director Quality Operations

UnitedHealth Group-posted 3 months ago

$110,200 - $188,800/Yr

Full-time • Director

Onsite • Eugene, OR

Insurance Carriers and Related Activities

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For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. Responsible for planning, directing and strategic oversight of the programmatic functions of the OptumCare Oregon (OR) quality program supporting the care delivery organizations (CDOs) of the Oregon market.

Developing functional, clinic and site level-strategy, plans, and/or initiatives to support Quality and population health priorities in the Oregon CDOs
Data analysis and operational activities to identify opportunities and drive outcomes to improve Quality outcomes focused on delivery of reliable, timely and patient centered model of care, including but not limited to, HEDIS/Pharmacy, patient safety, value-based care (VBC) work, clinical guidelines, etc. in the CDO practices.
Responsible for coordinating with appropriate personnel to meet operational program needs, ensures compliance with state / federal health plan requirements, Medicare guidelines, HEDIS / STARS, CMS and health plan requirements
Practice transformation incorporates engaged leadership; quality improvement strategies; continuous and team-based relationships; organized, evidence-based care; patient-centered interactions; enhanced access; and care coordination in the Oregon CDOs
Assists in developing a culture of excellence, through benchmarking, communication of best practices, applying and sharing tools and techniques
Identifies and resolves technical, operational and organizational problems outside own team.
Integrates effective change management efforts in quality processes and team management
Partnering with and influencing our provider and clinic quality performance including but not limited to participating in orienting and educating physician practitioners in five Star quality and with quality operations team in conducting practice workflow assessments to identify opportunities for improvement and practice transformation
Collaborates with CDO operations teams, Advanced Analytics, Credentialing, IT, Optum CDO leaders, PNW quality operations team, and others to identify and implement key processes changes required adherence to best practice standards
Interfaces with health plans, government and regulatory bodies, pay-for-performance programs, and value-based contracts
Partners with local and national clinical pharmacy teams to coordinate and prioritize pharmacy Quality endeavors
Develops and manages yearly Quality work plan for Oregon CDO practices
Manages day to day Quality program including internal quality operations teams
Oversees clinical guideline development for Oregon CDO practices
Oversees HEDIS data submission teams and support strategic oversight of data abstraction strategy
Oversees patient experience strategy for Oregon CDO practices supporting CAHPS and HOS performance improvement
Provides support for the Quality Workgroup(s) and regional Quality Committee and Guideline Committees
Promotes a positive and productive work environment by acting maturely and responsibly, satisfactorily performing job responsibilities and conducting themselves in a professional, courteous and respectful manner toward fellow employees, physicians and patients
Must be facile at operating independently in new and ambiguous market scenarios
Must relate to other people beyond giving and receiving instructions: (a) get along with co-workers or peers without exhibiting behavioral extremes; (b) perform work activities requiring negotiating, instructing, supervising, persuading or speaking with others; and (c) respond openly and appropriately to feedback regarding performance from a supervisor
Performs all duties in a manner which promotes and supports the Core Values and Compact of
Integrates Lean principles, practices and tools to improve operational efficiency, reduce costs and increase customer satisfaction
Frequently must follow written and oral instructions as well as complete routine tasks independently
Completes annual compliance training on HIPAA/Privacy/Confidentiality/Non-Discrimination/Harassment/Integrity Statement and signs Agreements
Ensures confidentiality of patient information following HIPAA guidelines and OptumCare policies
Attends training to meet requirements of the job position and as needed or mandated by OptumCare policies, Div. of Occupational Safety & Health (DOSH), OSHA, L&I and other state/federal regulations
Has regular and predictable attendance
Performs other duties as assigned

5+ years of clinical or healthcare experience in clinical quality or population health management
5+ years of experience in a Manager/Director role with adaptable leadership skills with the ability to achieve results in a complex organization by aligning goals with employees and organizational needs
5+ years of experience implementing effective HEDIS programs and NCQA accreditation
Driver's License and access to reliable transportation

Passion and commitment to help change the way healthcare is delivered with a track record of developing successful, innovative and sustainable quality programs
Proven collaborator who has worked with quality improvement initiative to continually improve processes and effectiveness of quality measures
Expertise in quality improvement and knowledge of national and local quality measurement systems, reporting and the relationship between quality improvement and incentives
Highly developed interpersonal, leadership, communication, negotiation, organizational, analytic and team building skills
Strategic comprehension of an evolving industry to include government regulations and competitive intelligence
Skilled at defining measurable success criteria to track progress towards achievement of quality and clinical integration strategies
Exercises active listening skill while understanding the needs and perspectives of others
Ability to establish and maintain effective working relationships with employees, managers, healthcare professionals, physicians and other members of senior administration and the population of OR

Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution

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