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



Approximate Salary:

Not Specified

Position Type:

Full Time

Manager of Clinical Quality - Albuquerque, NM

UHG - Albuquerque, New Mexico

Posted: 11/15/2018

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)


The Manager of Clinical Quality drives clinical relationships and engages with physician practices, members, and pharmacies while partnering internally (Network, Health Care Analytics, Medical Directors) with a goal of improving health, quality and practice performance. Positions are accountable for clinical practice performance which includes but is not limited to improvement on HEDIS and STARs gap closure, and proactively identifying performance improvement opportunities through the use of data analytics, technology, workflow changes and clinical support.

Primary Responsibilities:

  • Collaborate with cross functional teams on practice specific strategies to improve Medicare Stars
    ratings and accurate Risk Adjustment scores
  • Manage relationships with clients and physician practices
  • Drives performance through audits and coaching to team personnel to ensure products and services fully meet the client expectations while maintaining efficient and profitable operational delivery
  • Influences or provides input to forecasting and planning activities
  • Ensures team meets established performance metrics, performance guarantees, and quality

Required Qualifications:

  • Associates degree
  • 3+ years of healthcare industry experience
  • Familiar with Claims Systems and Operations
  • Experience with HEDIS, Medicare STARs and healthcare quality initiatives
  • Ability to interpret and analyze practice data
  • Provider-facing experience
  • Client relationship management skills
  • Teambuilding and leadership skills
  • Intermediate level of proficiency with MS Office (including Excel and PowerPoint)
  • Ability to travel in state to visit physician practices and field-based staff as needed about 10% of the time

Preferred Qualifications:

  • Bachelor’s degree or higher
  • 2-3 years of management or supervisory experience
  • Relationship building skills and ability to collaborate with internal and external partners (clinical and non-clinical personnel)
  • Experience with presenting to large groups
  • Project Management experience
  • Effective skills in motivating and mentoring others

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



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: HEDIS, Medicare, Medicare STAR, healthcare quality, quality improvement, leadership, manager, management, quality manager, practice consultant, CPC, clinical practice consultant, project manager, project management, supervisor, supervise, supervisory, analyze, analytics, Albuquerque, New Mexico, NM

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