Quality Improvement Consultant – Remote in Idaho

Requisition Number: 2270980
Job Category: Medical & Clinical Operations
Primary Location: Boise, ID, US
(Remote considered)

Doctor consulting nurse at nurse station.

UnitedHealthcare Community & State is excited to serve more members in Idaho and is seeking dedicated professionals to be part of our team. If you are enthusiastic about making an impact in healthcare, learn more at our upcoming Virtual Career Event, on March 11th, 12:00-2:00MDT.

Register to attend: https://uhg.hr/C&SIdahoInfoSession

At 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 equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. 

The Quality Improvement Consultant is responsible for the facilitation, implementation and coordination of the quality improvement and management program, including NCQA accreditation and HEDIS improvements and state specific quality initiatives. Through documentation collection and management, monitoring, measuring, and reporting on key metrics, the Quality Improvement Consultant assists the Idaho Quality team in meeting quality standards and state contractual requirements.

If you are located in Idaho, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

  • Develop and prepare documentation for NCQA and other accreditation survey submissions
  • Provide annual evaluation of program design and efficacy as well as development of work plans to address performance improvement
  • Collaborate with multiple functions that may include Clinical, Member Experience, Operations, Compliance, Network, Behavioral Services, and Pharmacy as needed to drive the quality improvement program
  • Initiate program improvement projects and activities to drive outcomes
  • Implement policies and procedures to align with program goals and compliance requirements
  • Represent the health plan and provide subject matter expertise at internal clinical and quality meetings, regulatory meetings, and any relevant community partner meetings, workgroups, etc.
  • Monitor and oversee execution of performance activities to improve health and quality outcomes and effective medical management (e.g., HEDIS, CAHPS)
  • Participate in or coordinate with other department projects as needed 

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 experience in the healthcare industry
  • 1+ years of experience with demonstrated functional knowledge of process improvement, quality improvement, and change management
  • Research experience
  • Proficiency with Microsoft Office Suite to include Word, Outlook and Excel
  • Proven excellent writing skills
  • Proven excellent verbal communication 
  • Ability to travel up to 25% of the time
  • Resident of Idaho

Preferred Qualifications:

  • Knowledgeable of the managed care / health insurance industry, products and services
  • Quality knowledge of HEDIS, CAHPS

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

The hourly range for this role is $28.61 to $56.06 per hour 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: 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.

Additional Job Detail Information

Requisition Number 2270980

Business Segment UnitedHealthcare

Employee Status Regular

Job Level Individual Contributor

Travel Yes, 25 % of the Time

Country: US

Overtime Status Non-exempt

Schedule Full-time

Shift Day Job

Telecommuter Position Yes

Our Hiring Process

We want you to know what our hiring process looks like. Watch the video and find out what to expect along the way.

What It’s Like

Watch the video and hear how our employees describe what it’s like to work here in Customer Service.

Careers at Optum

If you want to use your abilities to help us challenge the status quo and achieve on our ambitious mission, this is the right place for you. We are creating and delivering quality health care solutions that deeply impact the health care system. And this means opportunities for people like you to grow and innovate with us.

Closing the GAP

Our team members help close the gap in health care. Take a closer look and see how Lisa helps members navigate a complex health care system.