Performance Improvement Manager - San Diego, CA

Optum CA is seeking a Performance Improvement Manager to join our team in San Diego, CA. Optum is a clinician-led care organization that is changing the way clinicians work and live.

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you'll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

Provide leadership and operational management for quality and risk programs across the provider network. Supervises the daily activities of the performance team. Develops and implements quality improvement initiatives. Collaborates with internal departments and health plans to ensure compliance with IHA, HEDIS and CMS Stars initiatives. Responsible for annual quality data reporting and the audit process. Oversees the annual assessment program to ensure accurate documentation.

Position Highlights & Primary Responsibilities:

• 30% - Reporting - Monitor IPA performance and staff productivity. Analyze data to measure program effectiveness.
• 20% - Programs - Develop and monitor initiatives for ongoing IPA improvement. Create tools and materials for training and performance monitoring
• 20% - Client Relations - Works with the Director of Network Management to maintain positive and productive relationships between department staff, health plans, providers and members. Works with Provider Relations team to communicate with physicians and their staff. Meet with physicians as needed
• 15% - Staff Supervision - Supervises the daily activities of the performance staff, employee work schedules and work assignments to ensure effective business operations. Takes appropriate corrective action when required to improve employee performance in accordance with policy. Participates in the interviewing and hiring of new staff. Provides staff training as required
• 10% - Represents the MSO in state/regional meetings and conferences specific to quality. Including but not limited to IHA, health plans, IPA meetings, vendor user conferences
• 5% - Performs other 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 operations experience in a health plan, MSO or medical group environment and have a working knowledge of managed care principles
• Supervisory experience managing diverse areas of responsibility
• Quality Improvement experience
• Knowledge of regulatory requirements related to quality programs including NCQA's HEDIS, Medicare STARS and the Integrated Healthcare Assoc. AMP program
• Advanced knowledge of Microsoft Word, Excel, email and intermediate knowledge of PowerPoint, Access and other applications/information systems pertinent to managing data and conducting training sessions
• Experience in data analysis
• Reliable transportation, a valid CA Drivers License, and current car insurance meeting CA standards

Preferred Qualifications:

• Certificate in coding
• Familiar with claims processes, CPT, ICD-10 and HCPCS coding
• Solid customer service and professional communication skills, both written and verbal
• Excellent organizational and time management skills
• Ability to work on multiple, complex projects simultaneously

The salary range for this role is $89,800 to $176,700 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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