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.  

 

Primary Responsibilities:

Developing functional, clinic and site level-strategy, plans, and/or initiatives to support Quality and population health priorities in the Oregon CDOsData 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 requirementsPractice 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 CDOsAssists in developing a culture of excellence, through benchmarking, communication of best practices, applying and sharing tools and techniquesIdentifies and resolves technical, operational and organizational problems outside own team.Integrates effective change management efforts in quality processes and team managementPartnering 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 transformationCollaborates 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 standardsInterfaces with health plans, government and regulatory bodies, pay-for-performance programs, and value-based contractsPartners with local and national clinical pharmacy teams to coordinate and prioritize pharmacy Quality endeavorsDevelops and manages yearly Quality work plan for Oregon CDO practicesManages day to day Quality program including internal quality operations teamsOversees clinical guideline development for Oregon CDO practicesOversees HEDIS data submission teams and support strategic oversight of data abstraction strategyOversees patient experience strategy for Oregon CDO practices supporting CAHPS and HOS performance improvementProvides support for the Quality Workgroup(s) and regional Quality Committee and Guideline CommitteesAll staff members are to promote a positive and productive work environment by acting maturely and responsibly, satisfactorily performing his or her job responsibilities and conducting themselves in a professional, courteous and respectful manner toward fellow employees, physicians and patientsMust be facile at operating independently in new and ambiguous market scenariosMust 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 supervisorPerforms 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 satisfactionFrequently must follow written and oral instructions as well as complete routine tasks independentlyCompletes annual compliance training on HIPAA/Privacy/Confidentiality/Non-Discrimination/Harassment/Integrity Statement and signs AgreementsEnsures confidentiality of patient information following HIPAA guidelines and OptumCare policiesAttends 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 regulationsHas regular and predictable attendancePerforms other duties as assigned

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 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 needs5+ years of experience implementing effective HEDIS programs and NCQA accreditationDriver's License and access to reliable transportation

Preferred Qualifications:

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

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

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.  

 

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

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