Quality Management Consultant - M3P

UnitedHealth Group•Eden Prairie, MN

11h•Remote

About The Position

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 resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Quality Management Consultant (M3P) will support the Medicare Prescription Payment Program (M3P) Quality Management function. As part of this new program team, be part of an accountable strategic effort to ensure critical performance measures are available to internal business functions and external clients/health plans. Additionally, contribute to the regulatory requirements and audit activities through thoughtful evaluation of performance guarantees and service level agreements. Lead related root cause and remediation activities, in conjunction with business partners, and coordinate improvement opportunities within the billing, payment, and ledgering operations, along with additional teams supporting systems driving the end-to-end business process. Ideal candidates have prior experience evaluating business processes, contractual language, and guarantees – specifically with an understanding how to measure process effectiveness. The ability to coordinate and/or build appropriate and meaningful dashboards is essential to success in this role. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Requirements

5+ years of experience leading Quality-related continuous improvement activities with key internal business functions
3+ years of experience building and managing Quality/Performance dashboards, setting measurements/control plans and trend reporting
3+ years of experience facilitating development of escalation planning
3+ years of experience leading Rapid Root Cause Analysis (RCA) and remediation actions
Experience developing and measuring Performance Guarantees & Service Level Agreements
Experience using Power BI data visualization tools; intermediate skills with the ability to consult on report layouts
Intermediate to Advanced Excel skills with the ability to collect and chart data
Intermediate to Advanced PowerPoint skills and experience developing and delivering formal presentations

Nice To Haves

Project management experience
Medicare experience
SharePoint List development experience
Experience using Copilot
Intermediate Miro skills

Responsibilities

Build/Maintain process and data flow documentation, document handoffs between data storage and applications
Partner with program teams to translate process steps into visual process and data flows
Act as primary facilitators for program business processes (Run of Show)
Day-of facilitators for member and client impacting process workflows
Ensure data and narratives are complete and timely
Escalate issues to appropriate leaders for root cause/resolution
Prepare and report out end of cycle performance measures
Consult with key stakeholders to identify gaps in processes and data flows, seeking to build reportable measurement systems
Collaborate on best practice methods focused on prevention versus detection
Recommend performance targets
Coordinate data collection processes
Build/Maintain Quality and Performance Dashboards
Be a storyteller, create a structure for meaningful dashboards to depict performance over time
Ensure functional teams are capable to report out results for selected program controls
Identify opportunities to mature manual dashboards and controls in favor of self-serve, automated results
Improve overall program quality
Identify quality opportunities and improvements across all impacted applications and products
Contribute to the preparation of report outs with key internal business functions
Collaborate with internal teams to prepare for and execute internal process and external program audits
Use and promote internally-developed execution models, following the guidelines and best practices set by program leadership
Maintain program tracking tools and act as Administrators on key SharePoint sites