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



Approximate Salary:

Not Specified

Position Type:

Full Time

Director - Risk and Quality Portfolio Engagement- Denver, CO (preferred) or Telecommute

UHG - Denver, Colorado

Posted: 11/12/2018

Clinical Performance is charged with effectively implementing, monitoring, and executing on programs related to risk adjustment, driving affordability, and clinical quality activities across all lines of business for OptumCare a $9billion a year organization, touching over 9 million patients, 80 payers, and 22,000 providers. Enerprise Clinical Performance provides support to all markets served by OptumCare.


The Director of Risk and Quality Portfolio Engagement will be responsible for rolling out, managing, and overseeing Enterprise integration for on - going services proposals with external client. This role will be responsible for achieving P & L operating metrics, driving end to end stage for Statement of Work (SOW) commitments and any future integration. He / she will be responsible for driving Enterprise initiatives, manage project time frames, budget, and staffing requirements while leading others to make meaningful process improvements; will work collaboratively with all internal OptumCare organizations bridging gaps with any external client needs and ask to deliver upon, in deploying key initiatives and deliver upon project activities as needed.


This position will report to the Vice President of Clinical Performance for OptumCare and will be responsible for driving and implementation of all Enterprise program across OptumCare, with hierarchy of 15 - 20 individuals. There will be 5 - 8 direct reports and 10 - 15 indirect reports in to this position.


You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.


Primary Responsibilities:

  • Engagement Oversight:
    • Oversee, coordinate, perform and deliver on CDO program priorities and initiatives that relate to risk adjustment, quality and / or affordability
    • Direct responsibility for the successful execution of a large scale, cross functional program initiatives which are defined as highly complex, change oriented and of high visibility
    • Lead the effort to identify solutions (including scope, schedule and budget) so that recommendations can be presented to leadership. This may include creating business case, project plans, ROI calculations, revenue tracking for all large initiatives
    • Closely monitor project resources, tasks, risks and milestones and when necessary forecast impact on schedule, quality, and cost and make course corrections using defined change control procedure
    • Interacts with senior leadership and major stakeholders to establish strategic plans and objectives for programs or projects. Consults with business partners to clarify and define complex project requirements, budgets and business cases, including statements of work
    • Creates and delivers presentations on program or project goals and plans, including progress reports
    • Responsible for end - to - end program or project management, demonstrating ownership of the entire process from beginning to end. Develops and implements program and project level processes, procedures and performance metrics
    • May be responsible for sourcing, negotiating and managing outside vendors
    • Collaborate and coordinate with stakeholders and market representative’s teams to ensure the program progresses are on schedule, on time, within budget, quality performance, and delivery of projects. Assure alignment for inter - program dependencies
    • Identify improvement opportunities and coordinate with internal teams to deliver results in a defined timeframe
    • Manages physical, financial and human capital resources, considering budget and cost implication as well as risk implications of project decisions
    • Support the development and implementation of alternative project management approaches such as Agile to better align with changing work environments and speed to market
  • Management Oversight:
    • Provide leadership clear direction, coaching, and support to staff including hiring and developing top talent towards future
    • Ensures strategic staffing model is developed and maintained to support initiatives
    • Maintains professional network of key stakeholders across internal OptumCare Stakeholder and Clients. Able to leverage relationships developed through the course of tenure to ensure successful implementation and adoption of initiatives. Understands capability of customers, suppliers, and internal stakeholders to effectively engage resources to achieve overall success
    • Partners with all areas of the enterprise, inside and outside of the company, in the identification, evaluation, and selection of solutions that meet the business needs with an eye toward facilitating the creation of well - integrated solutions
  • Portfolio Management:
      • Drive Key Initiatives:
      • Deployment of One - Time Attestation
      • Chronic Disease Specific Campaigns
      • Operations Analytics and Reporting Portfolio
      • Chart Retrieval Program
      • Submissions and Reconciliation
      • Coding Education Program
      • Employee Development and Engagement Programs
    • Responsible for deployment of service agreements in place today with client across multiple States and Multiple SOWs
    • Assist with deployment and creation of One-Time Attestation Program and Chart Retrieval and Coding execution
    • Responsible of managing initiatives that may require overseeing onsite resources, scheduling and reporting process. This will include Attestation Deployment strategies such as with Employed and Non - Employed Physician groups
    • Provide subject matter expertise in areas including integration and deployment of large scale initiatives
  • Process Support:
    • Support the creation and maintenance of standards, methods, process, and procedures for project execution, reporting and communication
    • Manage the creation of tools that will generate executive briefing and early alert reports related to potential issues or budget shortfalls
    • Provide consultative services to identified markets and internal reporting / IT units on their project and risk management techniques, including methodology, assessment tool sets, and development of documentation
  • Financial Oversight:
    • Responsible for the oversight of the development of budgets for Project portfolio, ensure accountabilities are met for revenue driven through SOW
    • Orchestrate the integrated planning of annual budgets for the enterprise by partnering with finance teams
    • Play a key role in providing financial awareness to Program sponsors to assist in making funding decisions
    • Provide direction on tracking and reporting the financials associated with all spending, and overall resource management in support of the project program and portfolio

Required Qualifications:

  • Bachelor's Degree or 5+ years of additional experience to listed requirements in lieu of degree
  • 10+ years in an operations management, logistics or risk adjustment role responsible for managing staffing, training, logistics, strategy, issue management and resolution management
  • 10+ years of experience in leading and managing work teams
  • Intermediate to Advanced skills in MS EXCEL and PowerPoint
  • 50 - 60% Travel Nationwide (Typically Mon - Wed or Mon - Thurs) to meet with Leaders within the Delivery Care Organization

Preferred Qualifications:

  • Working knowledge of RA, STAR, and Clinical Workflow
  • 5+ years healthcare experience required; preferably in the healthcare services area such as nurse practitioner program, clinical workflow, risk adjustment operations, integration, deployment of technology and reporting
  • Effectively communicates complex ideas clearly and concisely to both internally and externally and with all levels of leadership including executive audiences
  • Able to create, build and maintain relationships to improve performance and establish trust and maintain creditability throughout the organization
  • Successful track record of leading large and complex multi - year program management initiatives with impacts across the business and organization as a whole
  • Demonstrates effective interpersonal, influence, collaboration and listening skills to address complex situations or issues
  • Experience in leading and directing cross functional teams to deliver projects within constraints of schedule, budget and resources
  • History of leading and possessing a high tolerance to stress and the ability to handle difficult situations in a confident and diplomatic manner within a large matrix organization
  • Provides leadership, organization and methodology to a multi - functional project team
  • Excellent time management, organizational, and prioritization skills and ability to balance multiple priorities and make changes to work as the project needs dictate. Able to accomplish in an ambiguous environment
  • Ability to drive projects by demonstrating decisiveness in resolving roadblocks inhibiting completion of milestones, making decisions and identifying priorities
  • MS Project, Visio and SharePoint skills

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)


*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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.



Job Keywords: Director Risk and Quality Portfolio Engagement, Denver, Colroado, CO or Telecommute, Telecommuting, Working from Home

Apply Now