Associate Director, Clinical Operations
UnitedHealthcare At Home
Clinic Operations Manager
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
This role receives direction operationally from the Associate Vice President of Clinic Operations and will work closely in collaboration with Primary Care physician leadership to improve quality, cost and patient service and the financial and operational performance of the organization. It will be the responsibility of this individual to ensure a positive and productive relationship with internal and external business partners as well as patients and providers.
Primary Responsibilities:
- Serves as a Lean Leader- Ensuring clinic operational efficiency
- Monitors division performance metrics; develops and implements action plans/corrective actions to address operational issues/concerns
- Leads the execution of various special projects/task forces/business improvement initiatives as requested by senior leadership
- Project management: Partner with internal and external stakeholders to accomplish goals and distribute work appropriately
- Ensure internal and external stakeholders are informed of progress, deviation from project plans and risks
- Serves as a leader or contributor to performance improvement initiatives; Responsible for successful implementation and achieving required metrics
- Serves as a change champion for all organizational initiatives (Operational / Patient Experience)
- Ensures performance improvement goals are achieved and sustained processes
- General oversight of day-to-day operations
- Serves as a subject matter expert for clinic operations
- Responsible for establishing partnerships with internal / external stakeholders for successful operations
- Sets, recommends, and achieves project timelines, appropriately manages, and reports on projects supporting larger operational goals
- Leverages tools and resources to effectively manage numerous large to small scale projects and successfully meets timelines, KPI's and expected outcomes
- Ensures patient care is of the highest quality and meets company standards
- Supports division administrator in developing positive employee/clinician relations
- Accountable for success of HEDIS, CAHPS, HOS measures within assigned region
- Responsible for achieving divisional and market goals and census growth
- Implement plans and processes to maintain productivity and profitability
- Identifies business trends that will affect the market, division, or clinics
- Ensures excellent customer service and satisfaction while achieving organization-specific financial goals
- Supports patient experience efforts, projects and is responsible for ensuring all C-I-CARE initiatives are implemented, adopted, and measured
- Responsible for CAHPS / HOS / BURKE data and results evaluation, and action plan development
- Regularly reviews patient experience initiatives that support continued improvement of scores
- Identifies opportunities to improve patient experience and partners with division administrators to develop tactics to improve patient experience
- Ensures financial success for assigned clinics
- Ensure financial reporting is fully utilized within each assigned clinic
- Supports annual budget development, volume forecasting and capital needs within assigned division/region
- Regularly reviews financial reporting, identifies opportunities for improvement and works with clinic leaders and AVP on improving financial outcomes
- Management and oversight of revenue cycle for assigned region/division of clinics- specifically managing clinic influenced issues such as denials, eligibility, co-pay, etc
- Partners with ancillary departments (billing/coding) to identify opportunities for improvement
- Provides leadership for Division Administrator, Operations Managers and/or Supervisors
- Supports division leadership team to ensure clinics achieve goals outlined for operational success
- Supports the recruitment, retention, and promotion of outstanding staff
- Responsible for developing and growing leaders within the assigned division ensuring turnover remains below identified threshold
- Supports practice leaders in meeting / exceeding their professional and operational goals
- Ensures best practices are followed and resolves incidents where the clinic is out of compliance
- Facilitates and maintains organization culture and values
- Accountable for:
- Performance management
- Year-in-Review (Annually)
- Talent acquisition/ turnover management
- VOICE survey results, action plans and ensuring success with creating a positive work environment
- Ensure leader/team member rounding is completed each month and included in monthly reporting
- Create regular 1:1 meetings with practice leaders to remain connected to clinic operations
- Provides training courses, articles, and other materials to support practice leader growth
- Supports teams with achieving/meeting goals and timelines
- Supports and influences the development of MAP goals; ensuring the goals support the continued growth and development of assigned clinics. Ensures the team achieves the approved MAP Goals and works to implement best practices for overarching goal success
- Supports the development of 90-day plans each quarter to ensure practice leaders meet goals
- Partner with multiple departments to provide staff with Education, Trainings, and resources that promote better understanding, improved skills, and growth
- Ensure 100% Compliance with all required MyLearning training as well as all Health and Safety required training and compliance
- Participate in physician and APC panel interviews with AVP and appropriate dyad clinician partner
- Facilitate clinician candidate site tours for clinics in their division
- Partner with recruitment, clinician leaders, and clinic manager or supervisor for successful onboarding of new clinicians
- Responsible for monthly divisional reporting & presentation related to performance
- Reviews and interprets financial reporting and dashboards to optimize clinic/regional operations
- Leverages monthly reporting guidelines to report on culture, finance, business/strategic and quality metrics to enhance and optimize operations
- Responsible for development of 'action plans' for operational areas requiring improvement (CAHPS, Voice Survey, Financial, Access, etc.)
- Responsible for ensuring organization best practice workflows and procedures are implemented and fully adopted. This includes developing and managing an audit process to ensure sustained compliance
- Regularly reviews and reports on observations, areas requiring improvement and actions to ensure 100% alignment with best practices
- Supports the development of best practices, ongoing training and ensuring assigned clinics (region) embraces a value-based care organization
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 in medical practice management, health plan operations or Medical Management in management positions with successive promotions
- 5+ years of thorough knowledge of capitation, physician recruitment, contracting managed healthcare systems, medical quality assurance, quality improvement and risk management
- Knowledge of (or ability to learn and apply to job function) state and federal laws, regulations, and compliance issues applicable to operating units
- Knowledge of ICD-10 / CPT / HCPCS and medical terminology
- Sound knowledge of financial and accounting concepts
- Well-developed knowledge of managed care principles and customer service best practices
- Proficient in Microsoft Office, Excel, OneNote, and Powerpoint
- Ability to travel among multiple assigned Primary Care Clinics
Preferred Qualification:
- Demonstrate ability to lead groups successfully coupled with sound interpersonal, excellent oral and communication skills
Pay 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
$112.7k - $193.2k
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