Job Description

Surgical Management Solutions is an early stage start up backed by Surgical Care Affiliates, a division of United Health Group. Surgical Managements mission is to empower consumers with the knowledge and education to understand their healthcare costs, coupled with seamless access and enhanced consumer experience when they need those services. Surgical Management Solutions was founded by SCA leaders after recognizing a substantial need to better reach and influence consumers to take ownership of their healthcare costs. Healthcare benefits are complex, and many consumers find themselves frustrated with the lack of transparency in the system and lack the simple means of understanding costs and how to access the care they need. The surgical management solutions model is intentionally designed to provide a simple solution to large, self-insured employers to drive down outpatient surgical spend. The model is built around the ability to engage and educate membership to create an exceptional member experience. The SMS goal is to empower members to be well-informed to be true consumers of healthcare. SMS streamlines services and impacts pull through by redirecting patients to the lower cost, higher quality setting of surgical care.

The Director of Clinical Operations is responsible for the development, implementation, and management of a strategic plan for our clinical quality program. The Director is responsible for managing and interpreting all aspects of clinical quality data, reports, reviews, workstreams and services related to clinical quality. Provides strategy, leadership, guidance, and oversight for all aspects of the clinical quality program to both internal and external stakeholders. Ensures innovation and differentiation is being developed and scaled in the marketplace to both our providers and clients. Acts as a liaison and clinical expert to our care advocate team that directly interfaces with SMS clients.

The Director of Clinical Operations reports directly to the Vice President of Strategic Operations

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

* Serve as a steward and leader of clinical quality and patient safety for SMS
* Possess excellent written and oral communication skills, ability to motivate teams
* Knowledge of accreditation standards, survey methodology and related tools and resources for regulatory and accreditation compliance and survey readiness.
* Strong organizational and leadership skills including conflict resolution
* Ability to influence stakeholders.
* Actively participates and contributes in enterprise Clinical Services communication, meetings, and strategic planning and execution with affiliates and parent company
* Establish guidelines and processes for managing and reporting on defined clinical outcomes
* Create clinical policies and procedures for managing the quality program with providers and clients
* Develop reporting and clinical dashboards
* Manage clinical workstreams in conjunction with Operations and Development
* Maintain regular communication with clinical leaders and peers of parent organization(s)
* Drive differentiation in managing and reporting outcomes through creativity and innovation
* Meet with facility and physician group representatives on defined basis to review outcomes as process defines
* Ensure accurate and updated clinical information for providers within Customer Resource Management.
* Partner with provider network to ensure appropriate access to quality outcomes for participants and customers
* Communicate facility issues or requests to appropriate SMS leader(s)
* Monitor and evaluate facility risk data for process improvement recommendations
* Collect, aggregate and present trends of data outcome trends to Operations to mitigate risk and establish action plans
* Develop and maintain strong business relationships with network providers, administrators and related business partners
* Oversee new provider orientation to maximize performance in gathering clinical quality data from providers
* Represent the program and company within the community through outreach and business development
* Own key relationships with providers, management companies, and practice leaders as needed
* Responsible for reporting quality metrics on a quarterly basis, at minimum
* Stand up Clinical Quality platform
* Establish plan to gather clinical scores from partnered independent ASCs
* Develop relationships and management process with partnered management companies
* Establish strategic plan for identifying trends and action plan using data
* Create and fine tune reporting and dashboard
* Establish process to gather quality data on front end
* Partner with Marketing and Communications for Clinical Quality campaign
* Create an ongoing scalable process for how we manage the quality tracking for the network ongoing, as well as quarterly QBMs to ensure compliance with network requirements
* Excellent customer service skills and aptitude for working collaboratively with healthcare providers
* Knowledge of healthcare industry and medical terminology
* Self-starter with high degree of drive, initiative, and follow through to meet deadlines
* Skilled at multi-tasking and communicating in a team environment
* Strong organization skills and ability to analyze internal and external information to impact sales decisions
* Must possess the ability to follow and anticipate trends impacting the marketplace
* Proficient in Salesforce and Microsoft Office

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

* Graduate of an accredited school of nursing
* 5+years of experience in nursing leadership that includes managing clinical outcomes and evaluating clinical quality programs
* 5+ years of experience in the Ambulatory Surgery Center (ASC)/Surgical Hospital industry and ASC operations
* Active membership in the Association of Perioperative Registered Nurses (AORN)
* Managed and Led Clinical Quality Programs.
* Experience working directly with physicians and/or physicians' practices
* Experience in Clinical quality data, reports, understanding services related to clinical quality.
* Knowledge of Clinical Database.
* Ability to travel 20% of the time
* If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained.

Preferred Qualifications:

* Bachelor's degree in Nursing, Public Health, Business Administration, Healthcare Administration or related field preferred
* Licensed Registered Nurse (RN-LPN) with current state license to practice, in good standing
* Specialty certification in OR nursing (CNOR) and/or Ambulatory Surgical Care certification
* Preferred experience working in managed care (a payor) and/or the clinical department with a large physician group, hospital, or management company.

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.

Colorado Residents Only: The salary range for Colorado residents is $130,300 to $250,200. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

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: Quality Clinical Programs, Telecommute, Telecommuter, Work from home, Work at home, Remote