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Associate Director, Quality

Optum
United States, New Mexico, Albuquerque
Nov 15, 2024

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

The Associate Director of Quality leads quality improvement and value-based programs in New Mexico. This role oversees the Quality Team, driving innovation to close quality gaps and improve HEDIS/Star ratings. The position is responsible for achieving 4+ HEDIS/Stars and collaborates with regional and market leaders.

Primary Responsibilities:



  • Lead and develop programs to improve HEDIS/Stars performance
  • Collaborate with VP of Population Health, Medical Director, and market leadership to meet quality goals
  • Present NM market STAR performance in various review meetings
  • Oversee and mentor the Quality Team in their daily tasks, including data abstraction and provider education
  • Develop STARS/HEDIS training materials and serve as the subject matter expert
  • Coordinate activities related to CMS Star program, HEDIS data collection, analytics, member/provider engagement, and surveys
  • Perform other related duties as assigned



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:



  • 3+ years of leadership experience in healthcare
  • Experience with Medicare and/or Managed Care
  • In-depth knowledge of NCQA/HEDIS, CMS Stars, and Clinical Quality Improvement
  • Proficiency in Microsoft Office applications
  • Proven excellent communication skills; ability to convey and interpret complex information clearly
  • Proven effective problem-solving and critical thinking skills
  • Proven ability to interact effectively at all organizational levels
  • Proven ability to review clinical data and recommend improvements
  • Willingness to travel locally up to 50%



Preferred Qualifications:



  • Registered Nurse or equivalent clinical experience/education
  • Certified Professional in Healthcare Quality (CPHQ)
  • Experience with billing and CPT coding



At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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