UnitedHealth Group
Fort Washington or Philadelphia

Clinical Quality Manager - Remote in Pennsylvania

Remote$91,700 - $163,700/yrPosted today

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Job details

Location
Fort Washington or Philadelphia
Work type
Remote
Compensation
$91,700 - $163,700/yr
Posted
today
Apply on
uhg.taleo.net

About this role

%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EAt 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 optimized. Ready to make a difference? Join us to start %3Cstrong%3ECaring. Connecting. Growing together%26nbsp;%3C/strong%3E%3C/span%3E%3C/p%3E%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Cstrong%3E%26nbsp;%3C/strong%3EThe Quality Management Manager will monitor and support the health plan quality improvement initiatives with particular emphasis on HEDIS, NCQA, and State Performance measures. You%27ll act as a voice for our members, guiding the development of comprehensive care plans that will help others live healthier lives.%3C/span%3E%3C/p%3E%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Cstrong%3E%26nbsp;If you are located in Pennsylvania, you will have the flexibility to work remotely* as you take on some tough challenges. This position will travel up to 10% in the PA market.%3C/strong%3E%3C/span%3E%3C/p%3E%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Cstrong%3E%26nbsp;Primary Responsibilities:%26nbsp;%3C/strong%3E%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EOversee the implementation of plan’s quality improvement program (QAPI)%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EWork to coordinate the work with the clinical, operations, and network teams to improve HEDIS and NCQA performance and to close gaps in care%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EManage Quality work plan programs and activities%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3ECollaborate across local and national business segments to achieve goals and targets%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EDevelop and maintain positive relationships with external state organizations within the scope of Quality Management%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EContinuously monitor HEDIS, NCQA, and state performance measure results and adjust programs to ensure targeted goals%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3ESupport Performance Improvement Projects, accreditation, and regulatory audits as needed%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EDevelop and mentor quality department staff%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EOversee quality quarterly review meetings with state partners%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EServe as panelist for grievance and appeal hearings%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%26nbsp;%3C/span%3E%3C/p%3E%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EYou’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.%3C/span%3E%3C/p%3E
%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Cstrong%3ERequired Qualifications:%26nbsp;%3C/strong%3E%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3ERN License in the state of Pennsylvania %3Cstrong%3EAND/OR%3C/strong%3E Master’s degree in a Healthcare Field (e.g. Public Health, Health Administration, Health Education, etc.)%26nbsp;%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EExperience with HEDIS and NCQA - quality improvement project experience%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EExperience managing staff or staff mgmt. for projects%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EExperience writing reports and managed care industry%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EExperience with outside audit organizations such as External Quality Review Organizations (EQROs)%26nbsp;%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EReside in the state of Pennsylvania and ability to travel up to 10% in the PA market%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Cstrong%3E%26nbsp;Preferred Qualifications: %26nbsp;%3C/strong%3E%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E2+ years demonstrated Management experience with responsibility for team performance management%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EQuality improvement experience within a health plan%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EExperience with excel (working with pivot tables) and creating PPT presentations%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EMedicaid experience%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EClinical experience/background%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EAbility to make independent decisions%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EChange management experience and demonstrated skills%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EAbility to complete various deliverables utilizing scholarly writing and AI technology%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EExperience with outside audit organizations such as External Quality Review Organizations (EQROs)%26nbsp;%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EExperience with managed care and insurance industry%26nbsp;%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EExperience in writing reports and analyzing performance data%26nbsp;%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EExperience creating detailed reports and project management%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%26nbsp;%3C/span%3E%3C/p%3E%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy %26nbsp;%3C/span%3E%3C/p%3E%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%26nbsp;%3C/span%3E%3C/p%3E%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EPay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from %2491,700 to %24163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.%3C/span%3E%3C/p%3E%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%26nbsp;%3C/span%3E%3C/p%3E%3Cp style=%22text-align:center;%22%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Ci%3EAt 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. %26nbsp; %26nbsp;%3C/i%3E%3C/span%3E%3C/p%3E%3Cp style=%22text-align:center;%22%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Ci%3E%26nbsp;%3C/i%3E%3C/span%3E%3C/p%3E%3Cp style=%22text-align:center;%22%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Ci%3E%26nbsp;%3C/i%3E%3C/span%3E%3C/p%3E%3Cp style=%22text-align:center;%22%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Ci%3EUnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. %26nbsp; %26nbsp; %26nbsp;%3C/i%3E%3C/span%3E%3C/p%3E%3Cp style=%22text-align:center;%22%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Ci%3E%26nbsp;%3C/i%3E%3C/span%3E%3C/p%3E%3Cp style=%22text-align:center;%22%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Ci%3EUnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. %26nbsp;%3C/i%3E%3C/span%3E%3C/p%3E

Job Details
Job: Quality Management
Primary Location: US-PA-Fort Washington
Other Locations: US-PA-Philadelphia
Organization: C&S Pennsylvania
Schedule: Full-time
Number of Openings: 1
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About UnitedHealth Group

UnitedHealth Group
Fort Washington or Philadelphia