Associate Director of Quality Programs - U.S.

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Company:
 		UnitedHealth Group
Company Profile | Current Opportunities (40)
Job Location(s): Reston
Employment Term: Regular
Employment TypeFull Time
Start Date:As soon as possible
Starting Salary Range:Not Provided
Required Experience: Open
Related Categories:Management and Supervision, Quality and Process Improvement, Healthcare - Administration/Billing

Position Description

Job Description - Associate Director of Quality Programs - U.S. (310367)
Job Description
Associate Director of Quality Programs - U.S.-310367
Description
AmeriChoice is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at AmeriChoice.
We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.
Associate Director of Quality Programs: US
Position Description:
Positions in this function include those responsible for supporting a variety of functions in areas such as health clinical quality program implementation throughout the organization that includes but is not limited to improvement, monitoring and assessment; HEDIS improvements; NCQA accreditation; quality regulatory compliance; and oversight of quality of care/service issues resolution. Also responsible for identified processes in clinical quality improvement and management programs including accreditation and regulatory requirements.
  • Supports the Director in the development, implementation and monitoring of national, federal and state required quality activities throughout the AmeriChoice health plans
  • Manages staff providing ongoing oversight of health plans' quality programs and work plans, including implementation of contract required activities to improve HEDIS and other quality metrics, maintain state regulatory compliance and accreditation requirements
  • Coordinates activities with other national quality staff/departments for quality program implementation, NCQA accreditation activities including HEDIS/CAHPS reporting and associated activities as well as quality improvement activity
  • Conducts clinical quality audits and may also be responsible for and/or support areas such as NCQA accreditation, provider and member satisfaction, service metrics monitoring and improvement as needed, access and availability, Quality Of Care/Service complaint monitoring and reporting, and provider credentialing.
  • Supports the reporting and analysis of member care quality and patient safety including the development of plans and programs to support continuous quality improvement using HEDIS and other tools.
  • Supports/facilitates assigned National Quality Committees
  • Supports the review/revision and approval of the National QI Program, National QI Work plan, and the National QI Program Evaluation as well as the implementation of each in the health plans.
  • Working with health plan quality staff, supports the facilitation of quality health plan committees such as the Quality Management Committee and the Provider Affairs Subcommittee and participates as appropriate in national quality meetings
  • Acts as Quality Subject Matter Expert, including but not limited to RFP responses
  • Provides work direction and manages performance of multiple direct reports
Locations listed are preferred, but other locations may be considered. You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.
Qualifications
Qualifications:
  • Clinical Registered Nurse with current licensure preferred
  • Bachelor's degree in Science or Business required; Masters degree preferred
  • 8+ years clinical practice experience preferred
  • 5+ years experience in managed care quality department experience required
  • 4+ years demonstrated leadership and team development skills
  • 4+ years of proven success managing, implementing and auditing clinical quality programs required
  • Experience as a corporate quality manager with responsibilities for multiple health plans required
  • Knowledge of NCQA accreditation process and standards preferred
  • Proficiency in software applications that include, but are not limited to, Microsoft Word, Microsoft Excel, Microsoft PowerPoint
  • Demonstrated ability to assist with focusing activities toward a strategic direction as well as develop tactical plans, drive performance and achieve targets
  • Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
  • Excellent 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.
  • Certified Professional in Healthcare Quality (CPHQ) certification preferred
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Job Quality Management
Primary LocationUS-CT-Trumbull
Other LocationsUS-VA-Reston, US-MN-Minnetonka, US-AZ-Phoenix, US-PA-Pittsburgh, US-NY-New York City
Organization Quality Management
Schedule Full-time
Number of Openings 1

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