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Georgia Market HEDIS/ STARS Quality Manager- Atlanta, GA or Telecommute within GA

UnitedHealth Group

Atlanta, GA
Job Code:
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Job Details

Georgia Market HEDIS/ STARS Quality Manager- Atlanta, GA or Telecommute within GA(Job Number:706362)

We have made a promise to the seniors we serve that we will support more effective care with networks focused on quality outcomes, a patient - centered clinical model and more members in high - quality rated plans - all delivered at the lowest medical costs and meeting and exceeding the expectations of CMS. The Market HEDIS / STARS Quality Director is accountable for defining, leading and coordinating all local initiatives in assigned markets for improvement of CMS Star ratings inclusive of overall quality and member satisfaction.
Primary Responsibilities:
  • Actively coordinate with all Medicare & Retirement national functions (Product, Sales, Marketing, Member Experience, Finance), UnitedHealthcare shared services functions (Network, Clinical, Quality, Operations) and Optum (Local Care Delivery, HouseCalls, Complex Population Management) functions to leverage local market knowledge and establish and drive local tactical plans for improving CMS Star ratings in assigned markets
  • Provide strategic and tactical direction to the field - based Stars resources (Practice Performance Managers and embedded Practice Resources); approve performance targets / metrics; ensure performance to targets.  Includes positive physician HEDIS run - rate performance; development and use of appropriate supporting tools (HouseCalls, CAHPS / HOS tools, documentation training)
  • Partner with local health plan team, Network, Market Medical Director and Optum to increase HouseCalls completion rates and reduce refusal rates
  • Drive all local quality improvement initiatives
  • Meet all assigned performance targets
  • Maintain strong relationships with Medicare & Retirement national functions, UnitedHealthcare shared services functions and Optum businesses through regular communications and face to face contacts
  • Exemplify and model Our United Culture and live our values with conviction

Job General Operations Management
Primary Location US-GA-Atlanta
Other Location United States
Organization M&R Market Mgmt - EAST Region
Schedule Full-time
Number of Openings 1
Apply on the Company Site

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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