Improve the lives of others while doing your life's best work.
SM Director Contract STARS Performance Improvement (880844) This
position has responsibilities for Quality Performance Improvement
activities for specific contracts across multiple geographies.
Serves on multiple Optum Clinical and Quality Committees and
leadership teams designed to provide strategic direction for all
local care delivery groups within Optum.
The Director, Contract Stars Performance Improvement provides
strategic direction, leadership and oversight for performance. This
role is responsible for planning, organizing, and directing the
administration of all Quality Programs\Strategies. Provides
leadership to and is accountable for the performance and direction
through multiple layers of management and senior level professional
staff. Responsible for coordinating with appropriate personnel to
meet operational program needs, ensures compliance with
state/federal health plan requirements, Medicare guidelines, NCQA
and health plan requirements. Provides long-term planning and
oversight to ensure activities are appropriately integrated into
strategic direction and operations, as well as the mission and
values of the company.
You’ll enjoy the flexibility to telecommute* from any location
within the Central Time Zone as you take on some tough
Provides leadership and support in establishing and directing
the Stars Program for specific contracts.
Develops and maintains policies and procedures that support the
corporate initiatives that meet State, Federal legal requirements
Collaborates with physicians to execute the implementation of
the Star initiatives as defined by enterprise and/ Optum LCDO.
Provides expertise to the training department on Star measures
and tools that support collection of and communication about
HEDIS/STAR to the enterprise.
Develops HEDIS/STAR member and provider engagement
Collaborates with WellMed executive team to execute HEDIS/STAR
Works with Optum LCDO Quality leadership team to provide
HEDIS/STAR reporting and to develop strategic direction.
Facilitates, integrates, and/or coordinates the implementation
and evaluation of identified CAHPS/HOS/quality
improvement/HEDIS/STAR activities as requested by UHG/UHC or
Promotes understanding, communication and coordination of all
quality improvement program components.
Participates in requested evaluations and audits for UHC and
other health plans.
Coordinates reporting on quality initiatives to all appropriate
Participates in various teams, committees and meetings at any
level required to maintain business necessity.
Maintains Star program documents, reports, and committee minutes
and follows all internal privacy and confidentiality policies and
Oversees the CAHPS/HOS survey process for all contracted health
Leads the coordination and completion of projects with
cross-functional teams and senior leaders across
medical/nursing/clinical functional areas to achieve targeted
clinical strategic performance goals.
Oversees medical/nursing/clinical workflow mapping, performance
monitoring, and coaching site visits in clinic settings using
process improvement methodologies to identify workflow gaps and
establish future-state recommendations.
Directs medical/nursing/clinical best practice identification
and standardization adoption in clinical settings with
cross-functional teams and senior leaders.
Directs and promotes clinical support for clinic staff and
nursing roles (RN/LVN Health Coach) with subject matter expertise
and resources for population management, nurse advocacy and
development opportunities, and nurse coaching/feedback
The pace is fast and you’ll need to be comfortable managing
multiple priorities. You may be required to work in multiple
locations, so scheduling flexibility is essential. You must also be
able to respond calmly and effectively in emergency situations.
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.
This role has the opportunity to telecommute within the Central
BA/BS degree in healthcare related field; clinical background
(Registered Nurse or Nurse Practitioner).
6+ years of management-level experience in managed care Quality
programs, including 5+ years of experience at the Director level or
Demonstrate knowledge of the business environment and business
requirements (e.g., strategy changes, emerging business needs)
Knowledge of CAHPS, HOS, NCQA HEDIS requirements and CMS STAR
Ability to establish and maintain effective working
relationships with employees, managers, healthcare professionals,
physicians and other members of senior administration and the
Excellent verbal, written communication, presentation, and
Knowledge of fiscal management and human resource management
Ability and willingness to travel both locally and non-locally
as determined by business need.
Careers with WellMed. Our focusis simple. We’re innovators in
preventative health care, striving to change theface of health care
for seniors. We’re impacting 380,000+ lives, primarilyMedicare
eligible seniors in Texas and Florida, through primary
andmulti-specialty clinics, and contracted medical management
services. We’vejoined Optum, part of the UnitedHealth Group family
of companies, and ourmission is to help the sick become well and to
help patients understand andcontrol their health in a lifelong
effort at wellness. Our providers and staffare selected for their
dedication and focus on preventative, proactive care.For you, that
means one incredible team and a singular opportunity to do
yourlife’s best work.(sm)
*All Telecommuters will be requiredto adhere to UnitedHealth
Group’s Telecommuter Policy.
Diversitycreates a healthier atmosphere: UnitedHealth Group is
an Equal EmploymentOpportunity / Affirmative Action employer and
all qualified applicants willreceive consideration for employment
without regard to race, color, religion,sex, age, national origin,
protected veteran status, disability status, sexualorientation,
gender identity or expression, marital status, geneticinformation,
or any other characteristic protected by law.
UnitedHealthGroup is a drug-free workplace. Candidates are
required to pass a drug testbefore beginning employment.
Job Keywords: San Antonio, TX,Texas, Telecommute, Telecommuter,
Telecommuting, Work from home, Work at home,Remote, STARS, NCQA,
HEDIS, quality, Director, CAHPS, CMS, Medicare, CST, Central Time
Requisition Number 880844
Job Title Director Contract STARS Performance Improvement
Job Family Medical and Clinical Operations
Business Segment OptumCare
Job Location Information Other Locations Chicago, IL
UnitedHealth Group is committed to working with and providing
reasonable accommodations to individuals with physical and mental
disabilities. If you need special assistance or accommodation for
any part of the application process, please call 1-800-561-0861 and
press or say 1 for Applicant to be connected to Recruitment
Services. Recruitment Services hours of operation are 7 a.m. to 7
p.m. CT, Monday through Friday.
UnitedHealth Group is a registered service mark of UnitedHealth
Group, Inc. The UnitedHealth Group name with the dimensional logo,
as well as the dimensional logo alone, are both service marks for
the UnitedHealth Group, Inc.
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.