Director of Performance Improvement - Pennsylvania Remote

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. 

This role addresses a significant need to bring quantitative focused discipline to performance improvement and bring expertise and bandwidth needed to help teams solve for program and performance challenges.  This position will report to the CEO and be assist with taking a closer look at optimizing how teams are getting their work done and whether the right prioritization of resources is being applied toward the most important goals.   Additionally, this role has a wide range of responsibilities including building programs and coordinating efforts to meet state contractual requirements around Value Based Contracting, CBO contracting, SDOH screening, workforce development, and health equity programs.   

If you are located in Pennsylvania, or within a commutable distance of Pennsylvania, you will have the flexibility to work remotely* as you take on some tough challenges.  This position requires travel of up to 10% for internal and external meetings throughout the state of Pennsylvania.

Primary Responsibilities:

• Clinical program optimization
  
  • Support Health Services with a data/measurement approach to evaluate which of our programs are working effectively and how to remediate programs that fall short of State expectations
  • Maximize MCO P4P dollars associated with the Maternal Home Visiting program and the BH Integrated Care Plan 
  • Resolve the data issues with BASIS and Health Services that do not allow us to track results well enough to satisfy the state during Quarterly Quality Review Meetings (QQRMs) and for regulatory reports.   This includes Community
  • Based Care Management results, Healthy First steps, Lead Screening, EPSDT, Care Model 2.0, Readmissions, Opioid Use Disorder, and Behavioral Health Integration
• Member Experience Improvement
  
  • Join Operations team in Call Calibration meetings to improve member service activity
  • Collaborate with Growth Team and Operations team in NPS/CAHPS improvement taskforce
  • Research opportunities across the organization to bring best practices to PA or to implement national solutions with Government Operations teams
• HEDIS Quality Improvement 
  
  • Partner with QM Director to help address upstream issues and data capture issues adversely impacting HEDIS
  • Resolve issues with how provider and member data is captured in CSP that impacts HEDIS numerators and denominators (e.g. race/ethnicity enrollment data, provider specialty data, member COB data)
  • Assist QSD team with research when results do not seem reasonable 
• SDOH Initiatives 
  
  • Resolve the performance problems with administration of screening by improvement of call script and identification of additional training needed.   Ensure appropriate referrals to resources during live calls take place
  • Address documentation problems for referrals in Find Help by training staff so that we can evaluate and have proof points of our SDOH work
  • Resolve SDOH reporting issues and analyze SDOH reports to identify high priority program needs
  • Present results to DHS during audits and quarterly status update meetings
  • Identify and meet with community based organizations that could potentially support member SDOH needs
• Workforce Development 
  
  • Maintain and develop relationships with external workforce development partners
  • Vendor Relationship Owner for GED works
  • Oversee work of staff on Retention team who make outbound calls and take inbound call transfers on opportunity to get help with GED and employment resources
  • Rebuild Contractor Partnership Program (DHS requirement to hire TANF/Medicaid members).   Involves working across UHG to find PA employment opportunities across all segments and find more effective ways to publicize these opportunities for our members
• Program Lead for miscellaneous DHS high priority initiatives
  
  • RAHC Initiative - Regional Accountable Health Council.   Organize staff resources to have meaningful participation and measure results
  • RISE PA - Currently scope of work being defined on a statewide resource and referral tool.   Work with national policy team to advocate for appropriate program design

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:

• 5 years of experience with Medicaid MCO strategy
• 5 years of experience in managed care operations 
• 5 years of experience building relationships with external entities
• 5 years of experience building relationships with state customers and executive partners
• 5 years of experience implementing new and large complex programs in a management or leadership role
• 5 years of experience working on data driven solutions, data analysis and/or reporting
• Ability to travel up to 10% throughout Pennsylvania for business

Preferred Qualifications:

• 5 years of experience in Finance or with responsibility for P&L/Financial results
• Proven ability to implement change, progress, and improvement by collaborating across departments in a large organization
• Demonstrated ability to drive a data, metric, and results-oriented solutions and program evaluation
• Demonstrated solid verbal and written communication skills

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

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for this role is $104,700 to $190,400 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.