Atlanta - GA Full Time 2 weeks ago

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)

The Director, Quality will be a key senior leader in the Quality department / West Texas Market. This leader will be responsible for identifying areas of opportunity and coordinating and implementing on this opportunity in conjunction with regional quality teams from a clinical first perspective. This position has responsibilities for Quality Performance Improvement activities for WellMed Medical Management across the West Texas Market. 

Provides strategic direction, leadership, and oversight for West Texas Market Quality performance and responsible for planning, organizing, and directing the administration of all Quality Programs. Provides leadership to, and is accountable for, the performance and direction through multiple layers of management and senior level professional staff. Responsible for coordinating with appropriate personnel to meet operational program needs, ensures compliance with state / federal health plan requirements, Medicare guidelines, HEDIS / STARS, CMS and health plan requirements. Provides long-term planning and oversight to ensure activities are appropriately integrated into strategic direction and operations, as well as the mission and values of the company.

The Director, Quality works closely and collaboratively with WellMed Central Quality.

If you are located within West TX, you will have the flexibility to telecommute* as you take on some tough challenges.

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:

  • Master’s degree in Healthcare or Business Administration (8 additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a master’s degree)
  • Active and unrestricted Registered Nurse license in Texas
  • 8+ years of management-level experience in managed care Quality programs required, including five or more years of experience at the Director level or above
  • Demonstrate knowledge of the business environment and business requirements (e.g., strategy changes, emerging business needs)
  • Knowledge of NCQA HEDIS requirements and CMS STAR requirements 
  • Knowledge of fiscal management and human resource management techniques

Preferred Qualifications: 

  • Excellent verbal, written communication, presentation, and facilitation skills
  • Ability to establish and maintain effective working relationships with employees, managers, healthcare professionals, physicians and other members of senior administration and the general public
  • Ability and willingness to travel both locally and non-locally as determined by business need

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Careers with WellMed. Our focus is simple. We’re innovators in preventative health care, striving to change the face of health care for seniors. We’re impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We’ve joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life’s best work.(sm)

WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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

Job keywords: Director, Quality, Managed Care, NCQA HEDIS, CMS STAR, Fiscal Management, Human Resource, HR, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, WAH, Abilene, Midland Odessa, San Angelo, Wichita Falls, Amarillo, Lubbock, TX, Texas

 

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