UHG

About UHG

Careers at UnitedHealth Group

 

We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Medical and Clinical Operations

Country:

US

Postal Code:

98101

Approximate Salary:

Not Specified

Position Type:

Full Time

Clinical Quality Manager - Seattle, WA

UHG - Seattle, Washington

Posted: 10/16/2018

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 and help people live healthier lives while doing your life's best work.(sm)   This position is office based in Seattle, WA with the potential to work from home 1-2 days per week after training and based on business needs.   Primary Responsibilities:

  • Manage the implementation and successful completion of the Medicaid and Medicare quality improvement program
  • Support member care gap closures through working with physician practices, Quality Improvement Interventions:  Responsible for maintaining or improving performance upon contractual and nationally required quality performance metrics, including HEDIS and customized state measures
  • Identify and prioritize key quality and utilization initiatives critical for the success of performance based payment programs. Management of external contractors:  Oversight of external contractors such as HEDIS contractor as needed
  • Prepare and present reports and updates at internal and external provider related meetings
  This position requires an experienced mid-market individual familiar with the general operations of a Medicaid and / or a Medicare plan and some familiarity with quality management within a Medicaid / Medicare market. This position will be responsible for management of professional staff. The success of the quality program also depends upon teams outside of the department that support critical activities and the ability to professionally communicate, influence and build relationships with departments and staff outside span of control within a shared services environment is critical to success.   In addition to leadership skills, a strong comfort with directing data acquisition is needed. Positions in this function are responsible for direction and guidance on clinical quality improvement and management programs.   This position is responsible for managing quality improvement and quality management programs. This position may be responsible for reporting and analysis of quality performance measures, oversight of audits related to regulatory contractual requirements, development of plans and programs to support continuous quality improvement using HEDIS measures and other tools and creation and submission of annual and quarterly submissions to various regulatory bodies.

Required Qualifications:

  • Bachelor’s degree or current, unrestricted RN license in the state with 4+ years of equivalent experience
  • 4+ years of healthcare experience
  • 4+ years of quality improvement experience
  • Experience in health plan data and outcomes measurements related to regulatory requirements
  • CPHQ or CHCQM OR ability to obtain within one year
  • Experience with Medicaid/Medicare
  • 4+ years of experience with MS Word, Excel, PowerPoint
  • Experience preparing and analyzing quality data

  • Experience with EMT optimization and clinical data integration

  • Experience working collaboratively across different teams

Preferred Qualifications:

  • 3+ years of experience in a manager or supervisor position
  • 4+ years of experience of Quality experience in a managed care setting
  • Experience managing and implementing quality improvement programs
  • Experience with determining strategic direction and developing tactical plans
  • Experience with analyzing problems, drawing conclusions and devising appropriate courses of action
  • Experience with conveying and interpreting complex information in a manner that others can understand

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)

 

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

 

 

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.

 

 

Keywords: Quality, CPHQ or CHCQM, Medicare, Medicaid, QI, Quality Improvement, Manager, Supervisor, Managed Care, health care, Seattle, WA, Washington

Apply Now