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VP Risk and Quality, Optum PNW

2 months ago


Seattle, United States UnitedHealth Group Full time

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Vice President, Risk and Quality is accountable for leading Quality and Risk Adjustment programs in the Pacific Northwest. The role involves leading a team in driving toward aggressive benchmark goals on STARs/HEDIS performance as well as clinical documentation (risk adjustment) across multiple care delivery networks and provider groups in Washington and Oregon. A dynamic leader is needed who is analytically driven, comfortable operating in a matrixed environment with many stakeholders, capable of driving a team to manage to results, and able to navigate a rapidly evolving network including the deployment of new technology platforms. Strong knowledge of managed care risk adjustment and quality programs is required, as well as a track record of successful operations leadership. The Pacific Northwest Population Health team reports to the Vice President, who will in turn report to the leader of Optum Care Network, Pacific Northwest, with dotted line accountability to the SVP of the Office of the Chief Medical Officer for Optum West.

Primary Responsibilities:

The VP Risk and Quality Optum PNW embraces the Eleven Roles of Managers as defined by the Common Language of Leadership. Such behaviors characterize how the VP gets work done on teams. These are leadership behaviors necessary for a VP to be successful.

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:

  • 10+ years of experience in a healthcare setting

  • 5+ years of management experience

  • 5+ years of experience in analytics and data analysis.

  • 5+ years experience in support of risk adjustment & quality activities, clinical informatics

  • Fluency in Microsoft applications

Preferred Qualifications:

  • Experience leading risk adjustment activities in a large Medicare HMO or provider organization

  • Knowledge of regulations related to Medicare Advantage, Medicaid, Commercial risk and quality programs

  • Knowledge of claim coding and payment methodology utilized in Medicare and Medicaid lines of business

  • Proven ability to interact effectively with C-Level employees across the organization

  • Proven ability to effectively direct preparation of various financial analysis and data mining activities

  • Proven ability to effectively interface with staff, clinicians and management

  • Proven solid leadership capabilities, and ability to initiate and maintain cross-team relationships

  • Proven excellent analytical, actuarial, and problem-solving skills

  • Proven excellent teaming/interpersonal and verbal and written communication skills

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Washington Residents Only: The salary range for this role is $147,300 to $282,800 annually. 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.

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: 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.