Senior Director STARS - HEDIS Payer Consulting - Telecommute

UnitedHealth Group Incorporated

Optum Payer Consulting is searching for a leader for its Medicare Stars consulting practice. This individual will be a help to drive consulting services, delivery and strategy around Medicare Advantage Organization (MAO) stars improvement, including the identification of client needs, the architecture of solutions, the development of business opportunities and the development of a best in class delivery team.

The successful candidate will understand the Medicare Stars payment system, MAO, Healthcare Effectiveness Data and Information Set (HEDIS) and other clinical quality measurement systems. This is a visible role requiring of the candidate excellent communications skills, the ability to define and promote a strong vision, the ability to motivate a committed and high performing team and have a passion and experience working to improve payer performance. It is quite simply the best job in health care for the right candidate:

Delivery, Thought Leadership and Business Development (75% Time Allocation):

Develop solutions tailored to market need, either through repackaging of current offerings or development of new offering. Overall guide processes and solutions
Function in a consultative role with key clients and accounts to deliver on Stars/HEDIS service offerings
Define the business development strategy for the practice

Identify opportunities for sales and business development collaboration with other Optum business segments and provide solution architecting for client engagements and service offerings
Provide Program and PMO oversight
Grow the practice and advance the practice capabilities by identifying and building the development of new consulting solutions that will be brought to market
Effectively build and maintain relationships with internal and external clients
Support sales effort through participation in pitches, development of marketing collateral, and personal involvement in speaking opportunities.
Support SOW development and assignment of staff / Proposal Writing

Operational and Staff Development (25% Time Allocation)

Monitor changes in regulatory environment governing payer quality bonus system (Medicare Stars), have strong understanding of CMS changes and the regulatory landscape and understand ongoing changes in scoring & quality metrics
Monitor market demand that results from quality bonus system
Support delivery effort through recruitment of delivery team, training of delivery team, and identification of core skills for delivery team
Writing and training efforts – supporting staff on the ground and developing staff
Staff development

Bachelor’s Degree, Master’s Degree in health or business related field preferred
5+ years payer experience required
3+ years Stars/HEDIS experience; measurements and process improvement
P&L experience
Experience working for an external consulting organization highly desired
Experience and credibility interacting with c-level executives as part of pursuit & delivery efforts
Experience developing new business and identifying add-on work
Experience writing and executing business plans for new consulting solutions
Experience leading a team of direct reports
Ability to travel up to 50-70%
Candidates located near Minneapolis, MN or Hartford, CT are preferred

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

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

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