Associate Director, Inpatient Quality Outcomes (Telecommute)

The Associate Director, Inpatient Quality Outcomes will lead, enhance and expand initiatives to improve quality outcomes of our United Healthcare Medicare members who have experienced an inpatient event.  You will be helping to improve the clinical experience of our members by using your clinical expertise to design utilization and quality management activities and initiatives that will assist providers in managing health outcomes of our Medicare members. You will design innovative programs that lead to successful transition of care across the continuum of care.  The right candidate will have experience in program development and leading staff across a matrixed organization with a strategic vision of the program at the forefront.  Looking for someone who is organized and can deal with complexity, while being innovative and flexible. Being a team player is a must.  Together we will design programs that will lead to successfully achievement of HEDIS requirements to prevent hospital readmissions, assure that members’ medications are reconciled when they return home, and facilitate a system to support members with acute and chronic health conditions to be treated in the optimal setting to facilitate quality outcomes.
 
Primary Responsibilities:

Provides leadership to and is accountable for the performance of managers and/or senior level professional staff
Develop, improve, influence and expand effective working relationships to support Medicare & Retiree Services and United Clinical Service executive leaders, as well as internal and external stakeholders
Build, develop and execute innovative strategies to optimize the effectiveness of the National Inpatient Care Management (NICM) team in supporting end to end process related to hospital inpatient Star measures
Build, develop, influence or expand program/projects or initiatives that positively influence Medicare Stars performance, create training  and monitoring mechanisms holding self and others accountable to daily operations and performance management
Provide data informatics and support clinical analytics at multi-levels throughout the organization
Educate, collaborate and partner with Community Care Transition and other UCS teams to improve the inpatient Stars measures across the continuum of care
Participate in UHC Stars meetings to represent NICM activities that contribute to hospital Stars measures
Negotiate priority initiatives and strategies with senior business leaders for the assigned Star measure
Create report presentations highlighting NICM specific performance and identify opportunities for performance improvement and ensure initiatives are in place to achieve goals
Design strategic focus across the NICM team and with inpatient providers to drive Medicare hospital Stars performance

Required Qualifications:

Must be a licensed registered nurse professional in home state required
4+ years of managed care management or quality program experience required
Minimum of 2 years in a leadership role preferred
Proven track record of successful clinical program design and implementation
Previous experience with clinical program development and implementation
Knowledge of HEDIS, Stars and coding/risk adjustment accuracy is preferred
Previous experience in a matrix, fast paced evolving work environment
Quality or Disease or Utilization management experience preferred
Must be able to clearly articulate an understanding and commitment to foster clinical integration among departments and contracted services
Proven ability to lead and influence a wide variety of clinical and senior business leaders
Must be savvy in business and financial acumen and be able to develop cost-benefit analysis and model staffing for various projects
 Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can 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.
 
 
Keywords: HEDIS, STARS, Managed care, RN, Registered Nurse, Quality, Disease, Utilization Management, Telecommute