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Associate Director Clinical Quality - Telecommute in Minneapolis, MN Metro Area

Company: Optum
Location: Minnetonka
Posted on: September 19, 2022

Job Description:

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

The Senior Quality Director provides strategic leadership and direction for the quality management and improvement program of UnitedHealthcare Community Plan of Minnesota.

The Senior Director works within and across matrixed health plan and shared service functions to develop and lead a proactive and evolving quality strategy, incorporating performance improvement, regulatory adherence, and accreditation compliance, for products and programs as directed by plan leadership. -This position provides strategic insight and direction to the plan to align with a changing health care landscape as it applies to quality reporting and clinical performance improvement. -This position develops and maintains strong relationships with state regulators, provides leadership input to expand and support member and provider engagement, and participates in advocacy activities at the state level. - The Senior Director is ultimately accountable for maintenance of the plan's accreditation, ongoing compliance with contractual requirements related to quality, and for coordinating multi-disciplinary quality improvement strategies to improve the plan's performance in care delivery and member health outcomes. - -

If you are located in Minneapolis, MN Metro Area you will have the flexibility to telecommute* as you take on some tough challenges. -

Primary Responsibilities:


  • Quality Improvement
  • Accreditation and Regulatory Adherence
  • Internal and External Advocacy and Relationship Management
  • Fiscal Management -
  • Employee Engagement and Development
  • Oversees the development and implementation of the plan quality program
  • Coordinates work across plan and shared services partners, utilizing the expertise, standard process, and capabilities of these areas to enhance health plan quality program performance -
  • Prioritizes work, including key deliverables such as the Trilogy Documents, Performance Improvement Projects, and annual performance measure reporting -
  • Directs quality improvement activities to improve outcomes for identified priority measures including but not limited to preventive care, chronic care, behavioral health care, potentially preventable events, and birth outcomes
  • Directs population health data analytics, enabling ongoing identification of improvement opportunities for populations served, and incorporating concepts of health disparities, social determinants of health, and health literacy into improvement strategies
  • Monitors shared services partners, holding them accountable for thorough and fully compliant performance measure reporting (e.g., HEDIS -, CMS 416)
  • Oversees the plan's compliance with accreditation standards and contractual requirements as they apply to quality, implementing programs and solutions as needed, and escalating risks when identified -
  • Develops and maintains positive relationships with the Agency for Healthcare Administration, state External Quality Review Organization(s), and other key regulatory stakeholders
  • Directs the health plan's Quality Improvement Committee and associated sub-committees, incorporating functional areas from across the organization to maintain integrated, holistic quality oversight -
  • Oversees and directs as applicable process improvement plans and corrective action plans for surveys, accreditation, state audits, etc., within the scope of quality management and improvement
  • Actively contributes to Invitation to Negotiate (ITN) responses, taking lead on assigned quality sections -
  • Oversees pilots, new, and ongoing programs in alignment with the quality budget, requirements for vendor compliance, and health plan expectations
  • Interviews, hires, and supervises quality department staff
  • Develops, mentors, and coaches staff



    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:


    • Bachelor's degree in nursing, public health, or a related field or equivalent experience
    • 3+ years of experience leading integrated and progressive health care quality improvement programs
    • 3+ years of significant leadership and managerial experience with direct reports in healthcare
    • 3+ years of experience with demonstrated functional knowledge, quality improvement initiatives and organizational behavior
    • 1+ years of demonstrated experience leading projects, tasks or staff
    • Experience leading accreditation surveys
    • Experience working closely with state regulators
    • Experience leading performance measure reporting (such as HEDIS, MIPS, CMS hospital measures, Joint Commission measures, etc.) -
    • Excellent communication and presentation skills for use with executive levels and regulators


      Preferred Qualifications:


      • Master's degree
      • CPHQ
      • Registered Nurse
      • Expert knowledge of the managed care/health insurance industry, products, and services
      • Knowledge of Medicaid requirements
      • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation



        To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.


        Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place 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.

Keywords: Optum, Minnetonka , Associate Director Clinical Quality - Telecommute in Minneapolis, MN Metro Area, Executive , Minnetonka, Minnesota

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