Performance Improvement Manager

UnitedHealth Group-posted 7 months ago
$89,800 - $176,700/Yr
Full-time • Mid Level
San Diego, CA
Insurance Carriers and Related Activities
Resume
Match Score
Upload and Match ResumeTrack Jobs with Teal

Optum CA is seeking a Performance Improvement Manager to join our team in San Diego, CA. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you'll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

  • Provide leadership and operational management for quality and risk programs across the provider network.
  • Supervises the daily activities of the performance team.
  • Develops and implements quality improvement initiatives.
  • Collaborates with internal departments and health plans to ensure compliance with IHA, HEDIS and CMS Stars initiatives.
  • Responsible for annual quality data reporting and the audit process.
  • Oversees the annual assessment program to ensure accurate documentation.
  • Monitor IPA performance and staff productivity. Analyze data to measure program effectiveness.
  • Develop and monitor initiatives for ongoing IPA improvement. Create tools and materials for training and performance monitoring.
  • Works with the Director of Network Management to maintain positive and productive relationships between department staff, health plans, providers and members.
  • Works with Provider Relations team to communicate with physicians and their staff. Meet with physicians as needed.
  • Supervises the daily activities of the performance staff, employee work schedules and work assignments to ensure effective business operations.
  • Takes appropriate corrective action when required to improve employee performance in accordance with policy.
  • Participates in the interviewing and hiring of new staff. Provides staff training as required.
  • Represents the MSO in state/regional meetings and conferences specific to quality.
  • Performs other duties as assigned.
  • 3+ years of operations experience in a health plan, MSO or medical group environment and have a working knowledge of managed care principles.
  • Supervisory experience managing diverse areas of responsibility.
  • Quality Improvement experience.
  • Knowledge of regulatory requirements related to quality programs including NCQA's HEDIS, Medicare STARS and the Integrated Healthcare Assoc. AMP program.
  • Advanced knowledge of Microsoft Word, Excel, email and intermediate knowledge of PowerPoint, Access and other applications/information systems pertinent to managing data and conducting training sessions.
  • Experience in data analysis.
  • Reliable transportation, a valid CA Drivers License, and current car insurance meeting CA standards.
  • Certificate in coding.
  • Familiar with claims processes, CPT, ICD-10 and HCPCS coding.
  • Solid customer service and professional communication skills, both written and verbal.
  • Excellent organizational and time management skills.
  • Ability to work on multiple, complex projects simultaneously.
  • Comprehensive benefits package.
  • Incentive and recognition programs.
  • Equity stock purchase.
  • 401k contribution.
Track Jobs with Teal

Job Search Resources

•
Resume Builder
•
Continuous Improvement Manager Resume Examples
•
Cover Letter Examples

Tools

Career Hubs

Guides

Company

© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service