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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

Quality Improvement & Outcomes Manager – Meridian, ID

UHG - Meridian, Idaho

Posted: 12/7/2018

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 Quality Improvement & Outcomes Manager develops, implements, and manages the QM program in collaboration with the Chief Medical Officer.  This person is responsible for overall quality improvement, including established standards, protocols, organization structure, ad hoc quality audits, committees, and training activities.  Communicates QI requirements to Sr. leadership and Executive Director and ensures required quality improvement standards of the contract are met.  Additional responsibilities include directing staff in their quality improvement functions on multi-disciplinary teams to assure adherence to quality standards.  Coordinating and collaborating with the State and other stakeholders in areas related to quality standards and requirements. 
Primary Responsibilities:
  • Develop, implement and manage the Quality & Training program and activities
  • Plan, implement and coordinate quality projects (PIPs) in collaboration with internal teams and external stakeholders
  • Oversee the Quality Committee structure, including:
    • Ensure all committee membership appointments (internal and external) as specified in the Quality Improvement program.
    • Ensure all committees are meeting regularly, track their action items and report status to the Quality Assurance & Performance Improvement (QAPI) Committee
  • Oversee the development and implementation and ongoing monitoring of the Quality Improvement Plan and Work Plan, including assessment of compliance with the State IDHW contract and regulatory requirements
  • Oversees the process for addressing quality of care (QOC) concerns
  • Oversee the development and implementation of the Provider Monitoring Plan
  • Ensure Quality Improvement program compliance with national and contract standards, and modify QI policies and protocols as necessary.
  • Maintain organization structure to support Quality functions.
  • Reporting on the status of quality projects for the state and senior management.
  • Manage, coach and develop direct reports. 
  • Other duties as assigned by the Executive Director

Required Qualifications:
  • Master's degree in behavioral health or related field
  • 3+ years of supervisory or management experience
  • 3+ years of experience working with regulatory and accreditation agencies and their QI requirements, including CMS, HEDIS and NCQA / JCAHO
  • Proficiency with MS Office applications and excellent writing skills
  • Research methodology and statistical analysis skills
  • Demonstrated success in implementing QI standards and practices across multi-department healthcare settings
Preferred Qualifications:
  • Certified Professional in Healthcare Quality (CPHQ), preferred
  • 5 years of mental health managed care experience required
  • 5 years of experience in quality oversight of clinical position in Healthcare industry, preferably in managed healthcare 
  • Project management experience in external audit preparation

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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)



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, Improvement, QI, CPHQ, managed care, CMS, HEDIS, NCQA, JCAHO, Supervisory, manager, Meridian, ID, Idaho

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