• Job Description

  Req#: 2174706

  At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life's best work.(sm)

  The Senior Director provides strategic leadership and direction for the population health and quality improvement programs of UnitedHealthcare Community Plan of Washington. The Senior Director works within and across matrixed health plan and shared service functions to develop and lead a proactive and evolving population health strategy and quality improvement infrastructure, incorporating performance improvement, program evaluation, 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 leadership position will be critical in fostering a team that prioritizes addressing health inequities in historically oppressed and underserved communities, in collaboration with those communities. This position develops and maintains solid 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 accreditations, 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. This role will supervise a team of quality specialists within the UHC Community Plan of WA. This role will collaborate with the Health Services Director and will report to the Chief Medical Officer.

  You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. This position may telecommute from anywhere in the United States. Preference for someone located in the state of Washington, or willing to relocate to the state of Washington.

  Primary Responsibilities:

  1. Population Health Management Program Oversight
  2. Accreditation and Regulatory Adherence
  3. Internal and external advocacy and relationships
  4. Quality Improvement
  5. Employee Engagement and Development
  6. Fiscal Management

  • Oversee the development and implementation of the plan’s Population Health and Quality Assessment and Performance Improvement programs
  • Coordinate work across plan and shared services partners, utilizing the expertise, standard process, and capabilities of these areas to enhance health plan performance
  • Prioritize work, including key deliverables such as the Trilogy Documents, Performance Improvement Projects, and annual performance measure reporting
  • Internal and External Advocacy and Relationship Management
  • Direct quality improvement activities to improve outcomes for identified priority populations, including but not limited to adult and pediatric preventive care, maternity care, care for chronic conditions, behavioral health care, members impacted by health disparities, and those with special healthcare needs
  • Direct population health data analytics, enabling ongoing identification of improvement opportunities for populations served, and incorporating concepts of health equity, social drivers of health, and health literacy into improvement strategies
  • Monitor shared services partners, holding them accountable for thorough and fully compliant performance measure reporting (e.g., HEDIS®, CMS 416)
  • Oversee 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
  • Develop and maintain positive relationships with regulators and other key regulatory stakeholders
  • Direct the health plan’s Quality Management Committee and associated sub-committees, incorporating functional areas from across the organization to maintain integrated, holistic oversight
  • Oversee and direct as applicable process improvement plans and corrective action plans for surveys, accreditation, state audits, etc., within the scope of quality management and improvement
  • Oversee pilots, new, and ongoing programs in alignment with the budget, requirements for vendor compliance, and health plan expectations
  • Interview, hire, and supervise department staff
  • Develop, mentor, and coach 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
  • 3+ years of experience leading integrated and progressive health care quality improvement programs
  • 3+ years of leadership and managerial experience
  • 3+ years of experience with process improvement initiatives and/or organizational behavior
  • Experience leading accreditation surveys
  • Experience working closely with state regulators
  • Experience leveraging nationally standard performance measure sets for monitoring of care and service
  • Expert knowledge of the managed care/health insurance industry, products, and services

  Preferred Qualifications:

  • Master’s Degree
  • CPHQ
  • Significant change management experience and demonstrated skill in staff development
  • Proven excellent written and verbal communication skills; superior communication abilities with executive leaders and regulators
  • Proven superior skills in influence and negotiation, team building, and motivation
  • Proven excellent planning and solid problem-solving skills; independent decision maker and risk taker
  • Proven commitment to anticipating, understanding, and meeting the needs of internal and external customers

  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)

  California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $118,000 to $226,800. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

  *All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

  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.

  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.

• About the company

  UnitedHealth Group Incorporated is an American multinational managed healthcare and insurance company based in Minnetonka, Minnesota.

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