UnitedHealth Group is hiring

Manager, Part D Quality Improvement - Telecommute job at UnitedHealth Group, Houston

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Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

As a Manager, Quality Management you will provide consulting services to strengthen and improve payor health care operations that result in stronger performance as demonstrated through HEDIS® and CAHPS® results as well as CMS Medicare Advantage Star ratings. You'll use your subject matter expertise in health plan quality management as well as Part D operations to provide strategic direction for meaningful performance improvement. In partnership with additional consulting staff, you will work closely with health plan clients to ensure their needs are captured, opportunities for improvement are identified and critical deliverables are executed. 

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. 

Primary Responsibilities:

  • Serve as a subject matter expert for the business processes related to quality management and improvement 
  • Serve as a subject matter expert for CMS Medicare Advantage Part D Star ratings
  • Evaluate the quality management structure and strategy of clients to identify improvement opportunities
  • Provide support and guidance on clinical quality and Part D operations, accreditation, and quality improvement initiatives
  • Support root cause analysis and develop targeted interventions designed to improve quality outcomes
  • Provide project management support for consulting engagements
  • Provide consulting support for client engagements
  • Assist in the development of written proposals and power point decks to support business development efforts
  • Support business development / sales efforts by serving as a quality management SME as part of client sales presentations and / or developing slide decks and written content to support RFP responses and client proposals 

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:

  • 5+ years of experience in health plan quality management (HEDIS®, CAHPS®, NCQA accreditation, and rating systems such as CMS Star ratings, Quality Rating System for ACA and State Medicaid measurement programs for health plans)
  • Experience managing the health plan and / or PBM strategy for Part D Star rating performance
  • Experience with Microsoft applications (Teams, Excel, Power Point, 365, Word, etc.)
  • Experience working multiple concurrent projects and ability to track time allocated across projects
  • Experience presenting findings and recommendations to internal and / or external stakeholders
  • Ability to travel up to 50% of the time, when safe and determined by client needs
  • Full COVID-19 vaccination is an essential requirement 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

Preferred Qualifications:

  • Pharmacy degree
  • Experience across multiple lines of business (Medicare Advantage, Medicaid, ACA, Commercial)

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 with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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)

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $97,300 to $176,900. The salary range for Connecticut / Nevada residents is $97,300 to $176,900. 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 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.

Job country: United States

City: Houston

Category: Business Operations Specialists, All Other

Location: Houston, TX, United States

Job posted 2022-06-04

This job is expired

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