Sr. Clinical Quality Analyst - Arizona - Virtual
Company: UnitedHealth Group
Location: Scottsdale
Posted on: May 25, 2023
|
|
|
Job Description:
At UnitedHealthcare, we're simplifying the health care
experience, creating healthier communities and removing barriers to
quality care. The work you do here impacts the lives of millions of
people for the better. Come build the health care system of
tomorrow, making it more responsive, affordable and equitable.
Ready to make a difference? Join us and start doing your life's
best work.(sm)
Do you enjoy working with both providers and members to address
care gaps? Become part of our team and build high value
relationships with providers in assigned areas to drive member
health outcomes. Proactively identify issues that hinders provider
relationship with plan. Continuously look for innovative channels
to engaging both members and providers at a higher level.
If you are located in Arizona - 25% travel in state, you will have
the flexibility to work remotely* as you take on some tough
challenges.
Primary Responsibilities:
Support STARS improvement projects, HEDIS, CAHPS measures and
provide clinical guidance
Monitor of reports and playbook
Support National Team efforts
Educate providers on general policies and procedures applicable to
delivery of care
Educate providers on proper HEDIS documentation/coding for member
compliance
Conduct regular visits to providers to introduce new initiatives
and monitor success of those in place and to identify issues and
ensure effective problem resolution to maintain solid
relationships
Serves as the primary point of contact, consultative resource, and
subject matter expert in all aspects of medical record
documentation requirements and coding as they apply to CMS
Stars/HEDIS measures
Closely working with internal stakeholders and providers to engage
members and close care gaps
Regularly checking Practice Assist for inpatient stay members,
notifying provider and/or scheduling telehealth visit with provider
for member
Weekly and monthly productivity reports for outreach (Corral,
Provider Letter campaign, Compassion Cards)
Member/Provider outreach to address care gaps. Following up with
provider (fax, email, mail, phone call, face-to-face)
Identify and implement opportunities to improve rates or efficiency
of data collection
Ensure projects are completed on time and in scope
Support Health Plans as Subject Matter Expert of STARS and HEDIS
Technical Specifications, project plans, and reporting
logistics
Support the evaluation and monitoring of State specific QM
Metrics
Need to work independently and within an integrated team in a
highly matrixed environment
Attend weekly/monthly and ad hoc Webex meetings with national
partners (National Star Operations Meetings, Stars Measure
Meetings, and Various measure groups, etc.)
Travel locally in Arizona (50 -75%) to meet with provider groups
and healthcare quality or policy organizations
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:
Registered Nurse with no restrictions in Arizona required to
practice
3+ years of experience working in a healthcare environment
3+ years of experience of project management
3+ years of experience in tracking, working with large data sets
and making data-driven analytical decisions
Experience working with provider relations
Intermediate or higher level of proficiency with Excel and
PowerPoint, including visual representation of quality data and
trends, use of basic math and statistics functions
Proven flexibility and quick adaptation to change is key
Proven continuous improvement mindset
Access to reliable transportation with valid driver's license that
will enable you to travel to client and/or sites within designated
area
Candidate must be based in Arizona (Phoenix, Tucson, or Mesa)
Full COVID-19 vaccination is an essential job function of this
role. Candidates located in states that mandate COVID-19 booster
doses must also comply with those state requirements. UnitedHealth
Group will adhere to all federal, state and local regulations as
well as all client requirements and will obtain necessary proof of
vaccination, and boosters when applicable, prior to employment to
ensure compliance. Candidates must be able to perform all essential
job functions with or without reasonable accommodation
Preferred Qualifications:
2+ years of Medicare, DSNP Lines of business
2+ years of Stars, HEDIS measure technical specifications
UnitedHealth Group, Optum, or UnitedHealthcare experience
Community & State and or Medicare & Retirement experience
Demonstrated ability to communicate ideas clearly and concisely
Proven excellent time management, organizational, and
prioritization skills and ability to balance multiple
priorities
To protect the health and safety of our workforce, patients and
communities we serve, UnitedHealth Group and its affiliate
companies require all employees to disclose COVID-19 vaccination
status prior to beginning employment. In addition, some roles and
locations require full COVID-19 vaccination, including boosters, as
an essential job function. UnitedHealth Group adheres to all
federal, state and local COVID-19 vaccination regulations as well
as all client COVID-19 vaccination requirements and will obtain the
necessary information from candidates prior to employment to ensure
compliance. Candidates must be able to perform all essential job
functions with or without reasonable accommodation. Failure to meet
the vaccination requirement may result in rescission of an
employment offer or termination of employment
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 employees working remotely will be required to adhere to
UnitedHealth Group's Telecommuter Policy
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: 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: UnitedHealth Group, Scottsdale , Sr. Clinical Quality Analyst - Arizona - Virtual, Professions , Scottsdale, Arizona
|
Click
here to apply!
|
