[Hiring] Clinical Quality Manager @UnitedHealth Group

Role Description

The Clinical Quality Manager plays a pivotal role in advancing quality improvement and population health initiatives across the organization. Working closely with Health Plan Leadership, this role promotes an interdisciplinary approach to care, emphasizing health promotion, chronic disease management, and compliance with organizational, state, NCQA, CMS, and other applicable standards. The manager will lead the Clinical Practice Consultant team and collaborate with providers and community partners to drive performance and improve health outcomes. This includes coordination of outreach, data analysis and formal presentation to physicians, administrators, and community stakeholders.

If you are located within commutable distance of Omaha, NE, you will have the flexibility to work remotely* as you take on some tough challenges.

• Develop and implement data-driven strategies to support quality and population health initiatives
• Conduct data analysis to identify trends, gaps, and opportunities for improvement
• Monitor and support quality improvement projects and incentive programs through performance tracking and outcome measurement
• Ensure compliance with regulatory and state reporting requirements related to quality and population health
• Prepare and deliver written and verbal reports and presentations to Health Plan Leadership and external stakeholders
• Lead and delegate project tasks based on team members’ strengths, skill sets and experience levels
• Engage directly with providers and other key stakeholders to support quality initiatives and foster collaboration
• Influence and guide multidisciplinary teams, including external partners, on complex quality-related topics
• Coordinate the development of presentations and data analysis for physicians, administrators, and community partners
• Engage with ACO partners to develop expertise in value-based contracting and inform quality performance and potential for improvement
• Support integration of internal processes and partners to support provider education in Quality Improvement
• Support connection to community-based partners to support Medicaid priorities
• Travel may be required to support community events and provider engagement

Qualifications

• Active, unrestricted RN license in the state of residence
• 4+ years of healthcare experience, including managed care
• Experience in HEDIS/Star programs and NCQA standards
• Proficiency with MS Word, Excel, Visio, PowerPoint, and SharePoint
• Proven ability to lead cross-functional teams and manage complex projects

Requirements

• Certified Professional in Healthcare Quality Certification (CPHQ) or Lean background
• Solid organizational, time management, and prioritization skills
• Solid problem solving and analytical skills
• Excellent analytical, problem-solving, and communication skills
• Ability to influence stakeholders at all levels and drive initiatives forward

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)