Job Details

Explore opportunities with Kelsey‑Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi‑specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.Primary ResponsibilitiesThe Director leads the development and execution of the health plan's Quality and STARs improvement strategy, ensuring solid HEDIS and STARs performance. This role establishes key objectives related to clinical gap closure, disease management, health outcomes, and member experienceThe Director oversees the full lifecycle of member communications, collaborating with internal stakeholders to implement an effective annual communications plan across all product linesIn partnership with other health plan teams, the Director analyzes data and environmental factors to strengthen relationships with members, providers, and community partners, supporting the organization's overall member experience strategyYou'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 Qualifications8+ years of leadership/management experience in the Health Plan Industry and Operations, including experience in HEDIS clinical quality and process improvement8+ years in customer retention or a role requiring relationship management and/or marketing/sales and/or program development and measurementExperience with NCQA's HEDIS data submission process and auditsProven knowledge of CMS Quality Ratings, Stars ratings and NCQA accreditation measurements and methodologiesExperience in provider education programsProven working knowledge of CMS Risk Adjustment requirementsPreferred Qualifications5+ years of experience in health plan operationsAbility to be a critical thinker, evaluate merits of new and innovative ideas, and make sound decisionsDemonstrated solid influence, and the ability to partner with Clinical resources to enable practice transformationAbility to create solid relationships and work with Clinical Directors, Medical Directors, Sr. Leadership, as well as business and technology partners to plan, direct and develop clinical programsAbility to be a solid communicator and extremely comfortable presenting program objectives, scope, and process across segmentsPay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far‑reaching choice of benefits and incentives. The salary for this role will range from $112,700 to $193,200 annually based on full‑time employment. We comply with all minimum wage laws as applicable.OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.OptumCare is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.#J-18808-Ljbffr