CDQI RAF Implementatation Associate Director - Telecommute option - Full-time / Part-time

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).

CDQI RAF Implementation Associate Director

Position Summary:

CDQI is charged with effectively implementing, monitoring, and executing on government pay for performance programs with a special focus on Risk Adjustment and HEDIS. CDQI processes on a national level by providing support in all markets served by Optum Local Care Delivery.

The CDQI RAF Implementation Associate Director position will report into the Risk Adjustment Operations Director of CDQI and will be responsible for implementation of strategic Risk Adjustment initiatives across Optum Local Care Delivery. 

Responsibilities:

Implementation of:

•  Best practices for provider engagement


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  Provider incentives



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  Member engagement



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  Embedded clinical model



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  Equipment & Screenings



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  Vendor relationship owner across all markets



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  Training programs



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  Compliance programs

 Critical Success Factors:
• 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 the total CDQI process and provides constructive information to minimize problems and increase provider and market satisfaction.
• Partners with Local Care Delivery leadership teams and Optum management across markets to coordinate execution and implementation in all markets.
• Ensure activities are appropriately integrated into the strategic direction, as well as the mission and values of the company.

Required Qualifications:

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  Bachelor's degree or greater or equivalent experience



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



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  5+ years of previous experience in end to end operations program management and oversight



• Demonstrated experience building and maintaining internal and external facing client relationships


• 5+ years of combined previous data analysis, process documentation, and process improvement experience (to include root cause analysis and solutioning.


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  5+ years of previous experience interacting with business leadership 



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  Up to 30% or more travel required

  
  
Preferred Qualifications:
• Previous experience with CMS Risk Adjustment Programs
• Familiarity with Physician Practice Management or IPA Operations +
• Familiarity with government pay for performance programs a plus
• Strong knowledge of CMS Risk Adjustment and ICD-9 coding requirements and regulations
• Lead a complex or multifunctional/multi-location team/organization
• Proven experience managing organizational growth and change
• Well-honed communication skills (both written and verbal)
• Ability to build strong relationships across a variety of stakeholders
• Proficiency with Microsoft Office

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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


Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.


UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.