Manager, Part D Quality Improvement - Telecommute
Company: UnitedHealth Group
Location: Los Angeles
Posted on: June 25, 2022
Job Description:
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.
Keywords: UnitedHealth Group, Los Angeles , Manager, Part D Quality Improvement - Telecommute, Executive , Los Angeles, California
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