Friday , January 27 2023

United Healthcare Jobs – Senior Clinical Quality Program Manager

Website United HealthCare

Job Description:

The Senior Clinical Quality Program Manager will work closely with the Health Plan Quality Leadership to coordinate an interdisciplinary approach to improve member outcomes and provider performance. Primarily responsible for the development and/or on-going management and administration of clinical quality programs. Provides implementation support, measurement standards, and revisions as needed that incorporate applicable best practices with proven outcomes. This position will focus on tasks that occur in accordance with State of NC, CMS, NCQA or other requirements as applicable. The Position reports to the Supervisor, Clinical Quality.

This role may require travel to locally up to 10% of the time and up to 4 hours away from your residence on occasion. The individual must be comfortable with creating presentations and working with data to formally present information to physicians, administrators, other providers and community partners.

If you are located in the state of NC, you will have the flexibility to telecommute* as you take on some tough challenges. Travel will be required to State sponsored meetings and to the Greensboro or Raleigh office.

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Job Responsibilities:

  • Define specific program/process requirements and expectations
  • Evaluate workflows, efficiencies, and best practices to determine program/process specifications
  • Identify technology needs to support programs/processes and provide or coordinate system and reporting requirements
  • Collect and submit data to relevant agencies for accreditation or compliance review
  • Use a process driven approach to identify root cause and process improvement opportunities (e.g., DMAIC method, Six Sigma, PDSA, Pareto charts)
  • Monitor compliance against relevant process requirements
  • Identify opportunities to increase efficiencies or effectiveness and recommended program implementation or process changes
  • Use a process driven approach to identify root cause and process improvement opportunities
  • Oversee or assist with program or process implementation
  • Coordinate with others to develop program or process implementation plans
  • Leverage technology to develop and deliver presentations and/or training

Job Requirements:

  • Bachelor’s degree in clinically related field or public health or within one year of completion
  • 3+ years clinical experience in healthcare and/or insurance industry
  • 2+ years of quality improvement experience with responsibilities in the following areas: Model for Improvement and Plan-Do-Study-Act (PDSA) rapid cycle change, data analysis and interpretation, systems analysis, graphical display of data / information, public speaking, group leadership and facilitation, and demonstrated problem solving and critical thinking skills
  • Advanced proficient in software applications skills that include, Microsoft Word, Excel, PowerPoint, Visio
  • Advanced with creating presentations and working with data
  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice
  • Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a
  • UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Job Details:

Company: United HealthCare

Vacancy Type:  Full Time

Job Location: Greensboro, NC, US

Application Deadline: N/A

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