Senior Clinical Quality Improvement Specialist - Remote

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

Talk about meaningful work. Talk about an important role. Let's talk about your next career move. Delivering quality care starts with ensuring our processes and documentation standards are being met and kept at the highest level possible. This means working behind the scenes ensuring a member-centric approach to care. As a Senior Quality Specialist, you will monitor and support health plan quality improvement initiatives with particular emphasis on compliance with state and federal regulatory and accreditation requirements and HEDIS improvements. You'll act as a voice for our members, guiding the development of comprehensive care plans that will help others live healthier lives.

We're looking for a self-motivated healthcare professional with Quality Improvement (QI), accreditation and/or data analysis experience. In this position, you would analyze essential data and develop and implement QI initiatives. The Quality team is focused on improving the health of our members, enhancing our operational effectiveness and reinforcing brand and reputation for high - quality health plans. Join us and help guide our efforts to improve the patient experience and satisfy our health plan customers. It takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment.

Primary Responsibilities:

• Develop and support quality improvement activities and performance improvement plans by:
  • Gathering and analyzing data
  • Preparing written reports for internal teams and customers
  • Presenting analyses and working collaboratively to improve the member experience
• Assisting in developing strategic action plans including identification of objectives, goals and strategies
• Participate in designing, creating, implementing and managing quality improvement projects and initiatives in support of the behavioral health measures (HEDIS, other), working collaboratively with other teams when appropriate
• Interface with key departments, as necessary, in order to identify barriers, opportunities and interventions to improve performance on priorities
• Assume responsibility for data integrity among various internal groups and/or between internal and external sources
• Develop, analyze and monitor new, routine and ad hoc reports using multiple data sources and systems
• Prepare and facilitate committees and workgroups
• Conduct and manage outcomes of various studies that may include analyzing, reviewing, forecasting, trending and presenting information for quality management planning and management needs

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:

• 2+ years of experience in managed care, including Medicaid
• 2+ years of experience developing and implementing performance improvement projects or using data to develop intervention strategies to improve outcomes
• 1+ years of experience collecting, analyzing and presenting data
• Experience managing projects, including multiple projects simultaneously
• Knowledge and previous experience with national QI standards (NCQA, HEDIS®)
• Intermediate computer skills (Outlook, Microsoft Word, Excel, and PowerPoint) with the ability to navigate a Windows environment.
• Presentation skills (present reports to leaders/colleagues)
• Ability to organize groups and work independently
• Access to high-speed internet services along with space for home office set up

Preferred Qualifications:

• Experience working within an Optum or UHG behavioral health team is highly desired
• Six Sigma, IHI, or other Quality Certification
• Clinical behavioral health license (LCSW, LPC, LMFT, LMHC, etc.), or RN with psychiatric experience
• Experience creating reports related to quality improvement / performance outcomes

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, or Washington, D.C. Residents Only: The salary range for this role is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

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