Associate Director, Stars and Quality - Western​/States - Remote

Improve the lives of others while Caring. Connecting. Growing together.

Job Description
- Associate Director, Stars and Quality
- Western/Central States
- Remote (2389786)

Associate Director, Stars and Quality
- Western/Central States
- Remote - 2389786

At United Healthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us in making healthcare work better for everyone through people-led, responsible AI while
Caring. Connecting. Growing together.

Associate Director of Stars and Quality, Multi-State Contracts is accountable for both defining the strategy for getting UHC H-Contracts to 4+ Star performance on all membership within those plans and ensuring the strategy is carried out. These contracts cross states, markets and in some cases market CEOs; therefore the Associate Director of Stars and Quality must ensure all stakeholders are coordinating to drive high quality performance.

If you are located in Western/Central States, you will have the flexibility to work remotely
* as you take on some tough challenges

For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

• Devise, communicate, monitor and intimately understand the H-contract path to 4+ stars and coordinate with the Quality Field Organization, Accountable Care Organization Team, Optum Care, and M&R leadership on all activities that ensure 4+ star performances
• Be considered the center of the data strategy; meaning constantly be mining data to find all opportunities for performance improvement in all aspects of Stars performance including HEDIS Part C and D, operations (e.g., disenrollment, appeals etc.), CAHPS/HOS market level detail from various sources such as KPI, CAHPS/HOS surveys, offseason CAHPS/HOS surveys etc.
• Collaborate with the MEGA contracts owner team, National STARs and HEDIS measure owners, and the West Region team to develop contract and market strategies, discuss best practices, and look for opportunities to partner with vendors to support measure closure
• Create a year round HEDIS chase strategy with particular focus on spring collection and abstraction best practices; driving best in class rate max activities in coordination with HEDIS Ops, ACO, and QFO
• Actively coordinate with all Medicare & Retirement national functions (Product, Sales, Marketing, Member Experience, Finance), United Healthcare shared services functions (Network, Clinical, Quality, Operations), Optum (Local Care Delivery, House Calls, Complex Population Management), lines of business (M&R, DSNP, ISNP, Group) and local leadership (Local EDs, CEOs) to leverage local market knowledge and establish and drive local tactical plans for improving CMS Star ratings and quality for assigned H-Contracts
• Coordinate with Network, ACO Team, QFO, and Optum Care teams to provide Practice Performance Managers, Clinical Transformation Managers, and embedded Practice Resources strategic direction; approve performance targets / metrics; ensure performance to targets. Includes positive physician HEDIS run-rate performance; development and use of appropriate supporting tools (House Calls, CAHPS/HOS tools, documentation training)
• Partner with Network, Market Medical Director, QFO, ACO, and Optum to increase House Calls completion rates and reduce refusal rates
• Meet all assigned performance targets
• Maintain strong relationships with Medicare & Retirement national functions, United Healthcare shared services…