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Vice President Risk Adjustment (Clinical Performance)

UnitedHealth Group

Eden Prairie, MN
Job Code:
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Job Details

Vice President Risk Adjustment (Clinical Performance)(Job Number:725848)

OptumCare focuses on transforming healthcare one patient at a time. The Enterprise Clinical Performance (CP) division specifically addresses the patient documentation and quality of care component. Through CP, OptumCare is positioned like no other healthcare system pulling together its resources of risk adjustment and management, quality initiatives, IT, and data analytics to streamline and drive at patient information to put actionable data in the hands of providers who deliver the safest and optimal care possible. CP is the nerve center for OptumCare's national network of clinical systems to reshape the healthcare landscape, harnessing trends, forecasting and sculpting best practices for the industry. 


The VP Risk Adjustment will report directly to the Senior VP, Centers of Excellence. This position will be responsible for strategic leadership, direction and operational support for CP initiative programs throughout Optum’s local clinical care delivery systems. This area will focus on implementing, monitoring, and executing on government pay for performance programs with special focus on risk adjustment and HEDIS.

This role will work in close collaborative partnership with the Medical Director of CP and will plan, organize and implement CP processes on a national level by providing support in all markets served by Optum Local Delivery.



Primary Responsibilities:

  • Provide long range planning and oversight of CP department operations to ensure activities are appropriately integrated into the strategic direction, mission and values of the company

  • Provide leadership and oversight of all market operations for CP to ensure processes are completed timely in accordance with company objectives
  • Monitor and track actual versus expected performance to target areas for improvement
  • Assist in hiring staff for all markets and assuring adequate staffing is in place to meet market demands
  • Provide leadership and mentoring to management and staff in establishing objectives.  Effectively lead and energize team functioning across geography and time zones
  • Ensure continued development and implementation of training programs for CP and oversee development of resources/reference tools for departmental staff, providers and other clinical staff as necessary
  • Strive to improve operational efficiencies and make recommendations as appropriate; take ownership of the total CP process and provide constructive information to minimize problems and increase provider and market satisfaction
  • Partner with Local Care Delivery leadership teams and Optum management across markets to coordinate execution and implementation in all markets
  • Develop and govern the annual budget for CP department operations and implements plans to achieve budgetary goals
  • Professionally develops staff through effective identification and utilization of internal and external resources; conducts annual performance reviews and identifies high potential performers for succession planning purposes

Job Business Process & TQM
Primary Location US-MN-Eden Prairie
Other Location United States
Organization Local Care Delivery Shared Svc
Schedule Full-time
Number of Openings 1
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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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