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Director Clinical Quality, South Florida travel req.

UnitedHealth Group

Tampa, FL
Job Code:
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Job Details

746472 Director Clinical Quality South Florida travel req

Director Clinical Quality, South Florida travel req. (746472)

Position Description

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

The Director Clinical Quality position will provide leadership to a team of Practice Performance Managers in FL and is accountable for the performance and direction of Stars performance for provider practices in designated H contracts (health plans and markets) as well as other quality initiatives.  

Externally, this position will work key health systems and provider groups to help transform their practices to better manage the health and quality of their Medicare populations including HEDIS / Stars performance in incentive or risk programs.  This includes relationship building, assessments of current capabilities and process gaps, analyzing performance reporting, and action plan development.  They will lead and participate in meetings with providers to find new ways to collaborate; ensuring that our collective approach is patient and provider centered.  


Internally, this role with directly supervise a team of Practice Performance Managers and manage their day to day work and progress against individual, market and national goals.  The role will work through multiple layers of management and senior level professional staff, and impacts the entire health plan performance.  The position will lead the organization - across all matrix partners and across multiple layers of management and senior staff, with a focus on quality, member engagement, provider relationships, clinical care coordination and data / reporting - to develop the strategy, programs and tactics necessary to achieve quality and revenue outcomes on a sustainable basis.  

The outcome of this persons work will have a material impact on our Medicare Stars Ratings.


If you are located in South Florida you will have the flexibility to telecommute* as you interface with providers in the Tampa and surrounding area. Daily/regular travel up to 50% within this geography. 

Primary Responsibilities:

  • Development and execution of clinical and quality strategy related HEDIS and Part D Stars Improvements in partnership with Medicare Market CEO, Executive Director, Data Support, and other Optum and UHC parties as appropriate

  • Day to day leadership of the market’s Medicare Stars results 

  • Participation and leadership in provider meetings focused on HEDIS and Part D quality improvement, in partnership with Healthcare Advocates, UHC’s network management team, Practice Based Support and local Medicare leadership

  • Cross functional leadership and engagement with health plan, clinical accountable care teams, and operations

  • Regular reporting and updates to senior leadership, including Health Plan CEO and segment clinical and quality teams.  Development of PowerPoint and data packages

  • Leadership and support of achieving a minimum of 4 Star rating for assigned H contracts and for achieving 80% of our members in 4 Star or better plans

  • Direct management of PPM team and indirect matrix management of practice based support team

  • Participation in health plan senior leadership team

Required Qualifications:

  • 4 year degree
  • 2 years of experience working directly with Medicare Stars or HEDIS, Risk- quality programs
  • 1+ year experience managing team (10+)

  • 1+ year experience with provider practice relationships
  • Strong demonstrated communication and presentation skills
  • Experience analyzing and interpreting complex clinical data and analytics reporting
  • Proficient with Excel, Word, PowerPoint, Outlook

Preferred Qualifications:

  • Advanced Degree
  • MBA, RN
  • Experience with government programs
  • Previous EMR / EHR experience


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)



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



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.



Job Keywords:  Medical, Clinical, Director, Management, Medicare Stars, HEDIS, RN, South Florida, FL

Job Details

  • Contest Number746472
  • Job TitleDirector Clinical Quality, South Florida travel req.
  • Job FamilyMedical and Clinical Operations
  • Business SegmentOptumInsight

Job Location Information

  • Tampa, FL
    United States
    North America
  • Other LocationsSt Petersburg, FL
    Fort Myers, FL

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelDirector
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionYes
  • Overtime StatusExempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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