Associate Director Clinical Performance Management - Telecommute - Full-time / Part-time

This position is part of the Shared Services organization in our Population Health Management area with OptumHealth. This Service Delivery Lead (SDL) will service a portfolio of highly visible National Account clients with either a PHS (Personal Health Support) 2.0 solution or a CPHS (Custom Personal Health Support) solution in Lisle, IL. Position reports directly to the Executive Site Director (Jeffrey Sherrill). In addition to the responsibilities identified below, this is a highly customer facing role that will be constantly interacting with the customer, account management teams in Optum and UHC, clinical staff, and supporting overall account needs within UHG.

 
You will be empowered to do your best by leading complex operational projects throughout the organization. This Associate Director will determine time frames, funding needs, procedures for accomplishing projects, staffing requirements, allotment of resources to various phases of projects and lead others in the organization to make meaningful process improvements. You'll investigate non-standard requests and problems, make presentations to senior leadership, ensure project documentation is accurate and ensure projects are completed on time and within scope. Pertinent data and facts will be reviewed to identify and solve issues and mitigate risks.
 
Primary Responsibilities:

On a client by client basis evaluate trends and performance against book of business targets for key indicators and developing corrective action plans when required
Collaborate with account management, site operations leadership and program partners to execute action plans and monitor programs
Provide account management assistance with client presentations, interpretation of data, etc. around escalated member issues
Perform annual clinical analytical review on top accounts and others as requested and 1) Communicate variances to, or achievement of, committed metrics consistent with OptumHealth product definitions and / or performance guarantees and 2) Identify clinical product opportunities and make recommendations with defined value to support client population needs
Develop solutions based on client’s business requirements and/or internal operational process gaps; there is responsibility for working independently on complex clients, including those that require sophisticated integrations or new processes
Provide program and operational design oversight of customer implementations
Act as a clinical resource and subject matter expert (SME) to operational staff for innovative customer program design and development
Provide oversight of customer implementations, working independently on those that involve multifaceted clinical products and deliverables
Communicate client specific factors that may affect performance to account management, site operations and program partners including but not limited to: Client value drivers, Vendor issues, Network / clinical gaps, etc.
Review processes to identify barriers which may contribute to underperformance specified accounts
Propose alternatives in collaboration with site operations and program partners that are cost / benefit neutral
Act as a liaison / informational resource for external program vendors, internal partners, and peers. Also, as needed serve in a client facing role to represent OptumHealth products and services
Provide assistance to the operational site in preparing for all client and external audits and represent operations during the audits for clinical program changes and the advancement of solutions to currently identified gaps
Proactively identify best practices across sites and assist operational teams in implementing those same best practices in other sites when appropriate
 

Required Qualifications:

RN License
4 year Bachelors level education
5 + years in a managed care environment
5 + years of experience in operations inclusive of problem solving, process development and consensus building, preferably with multiple functions / departments
3+ years of external client facing or customer facing experience
3+ years of proven analytics experience (gathering / analyzing data, developing reports, identifying appropriate changes/improvements, creating action steps based upon findings)
Up to 25% travel
Proficient in Word, Excel, Access, PowerPoint
Strong working knowledge of clinical / healthcare operations
Preferred Qualifications:

Master’s Degree
Experience in utilization management, case management, disease management or discharge planning 
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: 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: PHM, Management, Director, Consulting, RN, Lisle, IL, Schaumburg, Illinois
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