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About UHG

Careers at UnitedHealth Group

 

We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Business Operations

Country:

United States

Postal Code:

33601

Approximate Salary:

Not Specified

Position Type:

Full Time

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Director - Enterprise Contracted Solutions - Tampa, FL

UHG - Tampa, Florida

Posted: 09/20/2018

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care.  Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life’s best work.(sm)

 

The Practice Support Unit is charged with effectively implementing, monitoring, and executing on wrap around services, and quality programs that promote patient health while improving the provider practice experience with a special focus on Medicare Risk Adjustment and HEDIS. 

 

This position will report into the Vice President, Enterprise Contracted Solutions, and will be responsible for developing relationships and driving implementation of Quality and Market Operation  initiatives across the organization.

 

The Sr. Director is responsible for managing market relationships, and providing market-focused support and value to WellMed's cross-functional departments.  This includes monitoring & providing transparency to results and assisting in issue resolution / escalation.  Effective facilitation and communication with leadership, clinical performance teams, and external business partners is imperative.

 

 

Primary Responsibilities:

  • Driving local engagement across all risk & quality initiatives

  • Assisting in the creation of program needs and goals

  • Monitoring local performance against targets and enterprise goals, and identifying associated opportunities

  • Incorporating best practices for targeted increase in metrics, provider/patient engagement and overall success of care deliver partners

  • Coordinating with internal Clinical Performance teams to support and drive execution at the local level

  • Ensure appropriate training is deployed and compliance levels are maintained

  • Responsible for integrated assessment program oversight, process development and strategic roadmap execution

  • Responsible for defining and implementing process for monitoring key operational performance metrics

  • Manages day to day operational requirements to ensure internal and market trends are meeting project timelines

  • Leads the development of a cohesive, modular program for integrated assessment initiatives

  • Responsible for the overall execution of the integrated assessment program across all key focus areas while ensuring key metrics and timelines are met

  • Ensures early detection of major risks and interdependencies & escalation as necessary

  • Develops plan to retain key capabilities at enterprise level for future initiatives

  • Ensure communication between the various stakeholders, business leaders and cross functional teams

  • Provides updates to senior executives on program operational activity

  • Creates dashboards and operational metrics to demonstrate program success

  • Manages activity of cross functional teams to help support reporting capabilities

  • Working in a matrix environment to drive efficiencies through influence

  • Seeks ways to improve job and operational efficiency and makes suggestions as appropriate

  • Takes ownership of FL-based wrap around services, and provides constructive information to minimize problems and increase provider and market satisfaction

  • Partners with cross-functional leadership teams and WellMed management across markets to coordinate execution and implementation

  • Ensure activities are appropriately integrated into the strategic direction, as well as the mission and values of the company

  • Performs all other related duties as assigned


Required Qualifications:

  • Bachelor’s Degree

  • 3+ years of experience in Medicare risk adjustment

  • 5+ years combined experience within managed care / health insurance industry experience in government relations, network management, and/or legal/compliance

  • 5+ years of previous experience in Program Management

  • 5+ years of previous data analysis, process documentation, and process improvement experience

  • 5+ years of previous experience interacting with business leadership

  • Previous experience managing a remote team

  • Advanced level of MS Excel Experience

  • 50% travel required

   

Preferred Qualifications:

  • Strong familiarity with government pay for performance programs and/or consulting background

  • Previous client facing role experience in program delivery / program management
  • Experience in Quality with a working knowledge of Star / HEDIS
  • Strong knowledge of CMS Risk Adjustment and ICD-10 coding requirements and regulations
  • Lead a complex or multifunctional / multi-location team / organization
  • Six Sigma certification and/or exposure
  • Proven experience managing organizational growth and change
  • Well-honed communication & presentation skills (written & verbal)
  • Strong execution and accountability across multiple projects and programs; independent delivery
  • Desire and ability to build strong relationships across a variety of stakeholders
  • Demonstrate visionary thinking and emotional intelligence

  

If the hired individual resides in Florida (office based or telecommuting) this position requires the AHCA Level II background check (fingerprinting) by the State of Florida for all clinicians that have direct face to face contact with members OR employees who will have access to confidential patient data and will require renewal every five years.

 

 

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 240,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

 

 

 

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.

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