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Market Quality Director - Telecommute in Texas or Oklahoma (883463)

Company: UnitedHealth Group
Location: Norman
Posted on: September 17, 2020

Job Description:

Improve the lives of others while doing your life's best work. SM Market Quality Director - Telecommute in Texas or Oklahoma (883463) The Associate Market Quality Director (MQD) provides strategic leadership and direction for the quality improvement program to the E&I line of business. The MQD works within highly matrixed relationships to lead and develop the overall quality strategy for the plan, ensuring the quality program is proactive, continuously improving to include quality management/improvement and regulatory adherence. This position provides insight and direction to the plan to align with a changing healthcare landscape as it applies to quality.

They are responsible for creating, driving and executing strategy to ensure optimal NCQA Accreditation results. Responsibilities including but not limited to HEDIS, CAHPS, NCQA Standards, driving deployment and relentless day to day operational monitoring, State/market and specific employer group needs, as applicable (e.g. FEHB, COA, COLA, or State of AZ as examples). The improvements will drive increased NCQA Accreditation status and stars ratings. Under the supervision of the Regional Quality Director (RQD), the MQD works closely with their Market Leadership including Market Chief Executive Officer (CEO), market Chief Medical Officer (CMO), UnitedNetwork and others.

The MQD is the population health expert for the market and assesses gaps in programs and disparities, proactively communicating the needs and driving innovation to find programs to work at the local or market level. The MQD understands and influences the National Member Engagement and Provider Engagement Programs deployed in their assigned markets and assures day to day oversight to close gaps in care and to improve clinical outcomes of our members.

You’ll enjoy the flexibility to telecommute* from anywhere within United States as you take on some tough challenges.

Primary Responsibilities:

Active and engaged member of the Market Leadership Team

Drives programs and initiatives to assure member access to care and gaps in care closure

Under the supervision of the RQD, partners with the Market Leadership to establish and ensure quality goals are met

Manages assigned market/state Quality Improvement goals to drive and track data capture and collection, provider engagement and value based contracting, member engagement programs, clinical, and customer care touch points

Aligns and coordinates deliverables within their market/region/state and among the team including but not limited to: HEDIS data collection, Data Analytics and Reporting, NCQA Accreditation, CAHPS Member Surveys, Regulatory Adherence, product filings, and Member Activation and Engagement

Displays innovative problem solving and upholds principles of continuous quality improvement

Meet annual goals and objectives for the market and key metrics in conjunction & under the direction of the RQD, shared services teams and corporate goals and strategies to meet and exceed established program objectives

Monitors daily, weekly, monthly, quarterly, semi-annual and annual reports against goals to assess program success and alignment and to identify opportunities for improvement

Accountable for and assists with the trilogy documents including the Quality Improvement Work plan, Program Description and Annual Evaluation

Accountable for quarterly Healthplan Quality Management committees meetings to support quality oversight. Examples may include: Medical Advisory Committee, California QIC, and Regional Quality Oversight Committee (RQOC)

Accountability for and knowledge of the Quality Improvement, NCQA Accreditation, and gap metrics for assigned market/state. Appropriate application of information to drive strategy within the market

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:

BA/BS degree in healthcare related field; or Clinical Registered RN with ADN degree is acceptable with commensurate demonstrated clinical experience or outcomes specified below

3+ years of significant and progressive leadership or managerial experience and responsibilities (does not have to include management of direct reports, since that is not a requirement of this position). Management of process or discreet work stream is acceptable

3+ years of experience in, and/or knowledge of, Clinical Quality and Quality Improvement processes

Intermediate proficiency with MS Office, specifically with Excel

Preferred Qualifications:

Clinical Registered Nurse

Advanced degree

5+ years working in managed care or a healthcare delivery system

Certified Case Manager

Certified Professional in Healthcare Quality

NCQA Accreditation

HEDIS and CAHPS expertise:

Excellent interpersonal skills

Superior verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others

Proven problem-solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action

Performance driven

Ability to work independently with minimal supervision

Team player

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is  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.

Job Keywords: Nurse, RN, Registered Nurse, Clinical Quality, Quality Analyst, Quality Improvement Coordinator, Clinical Quality Manager, Case Manager, HEDIS, STARs, NCQA, Telecommute, Telecommuting, Telecommuter, Work From Home, Remote, Houston, San Antonio, Dallas, TX, Texas, Oklahoma City, Tulsa, Norman, OK, Oklahoma

Requisition Number 883463

Job Title Market Quality Director - Telecommute in Texas or Oklahoma

Job Family Medical and Clinical Operations

Business Segment Employer and Individual

Job Location Information Houston, TX

United States

North America

Other Locations Oklahoma City, OK

Dallas, TX

San Antonio, TX

Norman, OK

Dallas, TX

UnitedHealth Group is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or accommodation for any part of the application process, please call 1-800-561-0861 and press or say 1 for Applicant to be connected to Recruitment Services. Recruitment Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through Friday.

UnitedHealth Group is a registered service mark of UnitedHealth Group, Inc. The UnitedHealth Group name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the UnitedHealth Group, Inc.

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, Norman , Market Quality Director - Telecommute in Texas or Oklahoma (883463), Other , Norman, Oklahoma

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