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Clinical Quality RN

Company: UnitedHealth Group Inc.
Location: Salt Lake City
Posted on: April 18, 2019

Job Description:

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm)This position will drive consistency, efficient processes and share best practices - in a collaborative effort with provider - designed to facilitate a minimum 4 Star rating. The candidate will participate in quality improvement initiatives, develop recommendations, and implement strategies to capture relevant data for HEDIS gap closure.Primary Responsibilities:* Develop market business plans to motivate providers to engage in improving Star measures to be 4 Star or higher* Provide interpretation of Stars and HEDIS reporting, including executive summaries to provider groups* Be the primary go - to for all Stars related activities within assigned groups* Assist in development of training and analytical materials for Stars and HEDIS* Lead HEDIS / quality discussions in group meetings to summarize provider group performance and identify areas of opportunity* Analyze and evaluate provider group structure and characteristics, office operations and personnel to identify most effective strategies to reach goal* Develop solutions - based, user friendly initiatives to support practice successRequired Qualifications:* Current, unrestricted Utah RN licenses* 2 years of HEDIS / Stars experience* 2 years associated business experience with healthcare industry* Strong knowledge of the Medicare market, products, and competition* Experience in managed care plans working with network and provider relations* Local travel to provider sites to conduct data abstraction as needed. Up to 25% local travel* Access to reliable transportation that will enable you to travel to client and / or patient sites within a designated areaPreferred Qualifications:* Undergraduate degree preferred* Strong communication and presentation skills* Strong relationship building skills with clinical and non - clinical personnel* Ability to solve process problems crossing multiple functional areas and business units* Good business acumen, especially as it relates to Medicare* Professional experience persuading changes in behavior* Strong analytical background within Medicare Advantage plans (Stars modeling)Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)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: STARS, HEDIS, quality, RN, medicare advantage, abstraction, Optum, UHG

Keywords: UnitedHealth Group Inc., Salt Lake City , Clinical Quality RN, Healthcare , Salt Lake City, Utah

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