Manager Clinical Quality – Hybrid

For those who want to invent the future of health care, here’s your opportunity. We’re going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. 

The Quality Manager provides strategic leadership and supports quality improvement and value-based programs in Arizona. This position oversees the Quality Team and drives innovation and strategy that leads to quality gap closure and increased HEDIS/ Star ratings. The Quality Manager will report to the market Director and is responsible for achieving quality performance of 4+ HEDIS/Stars in the region and works collaboratively with regional and market leaders in a matrix relationship.

Primary Responsibilities:

• Provide strategic leadership and develop innovative programs that improve quality HEDIS/Stars performance in the market
• Partner with the Director of Quality, Medical Director, and market leadership to ensure established quality goals are met
• Participate and present AZ market STAR performance in weekly, Monthly, Bi-monthly, Quarterly and/or Annual Business Review meetings 
• Oversee and mentor the Quality Team in their day-to-day responsibilities including data abstraction, provider and clinical staff education, and practice specific business planning that motivates providers to improve quality performance
• Assist in developing STARS/HEDIS training and presentation materials and is the subject matter expert for all STARS-related activities within the market
• Aligns and coordinates activities and deliverables related to the CMS Star program, HEDIS data collection, Data Analytics and Reporting, Member/Provider
• Engagement, and CAHPS/HOS Member Surveys 
• Perform all other related duties as assigned

You’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.

Required Qualifications:

• 3+ years of progressive leadership experience preferably in healthcare
• Medicare and/or Managed Care experience
• Experience and proficiency using Microsoft Office applications, including Outlook, Word, PowerPoint, and Excel spreadsheets
• Solid knowledge of NCQA/HEDIS, CMS Stars and Clinical Quality Improvement
• Proven superior 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 
• Proven problem-solving and critical thinking skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action 
• Demonstrated ability to interact with all organizational levels
• Proven ability to review clinical data and provide recommendations for improvement
• Up to 50% local travel may be required

Preferred Qualifications:

• Registered Nurse or other related clinical experience or education
• Certified Professional healthcare Quality (CPHQ)
• Billing and CPT coding experience

The salary range for this role is $89,800 to $176,700 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives. 

At 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.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.   

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.