Manager Clinical Quality - Remote in NE Market Only

UnitedHealth Group•Omaha, NE

4h•$91,700 - $163,700•Remote

About The Position

The Clinical Quality Manager plays a pivotal role in advancing quality improvement and population health initiatives across the organization. Working closely with Health Plan Leadership, this role promotes an interdisciplinary approach to care, emphasizing health promotion, chronic disease management, and compliance with organizational, state, NCQA, CMS, and other applicable standards. The manager will lead the Clinical Practice Consultant team and collaborate with providers and community partners to drive performance and improve health outcomes. This includes coordination of outreach, data analysis and formal presentation to physicians, administrators, and community stakeholders. If you are located within commutable distance of Omaha, NE, you will have the flexibility to work remotely as you take on some tough challenges.

Requirements

Active, unrestricted RN license in the state of residence
4+ years of healthcare experience, including managed care
Experience in HEDIS/Star programs and NCQA standards
Proficiency with MS Word, Excel, Visio, PowerPoint, and SharePoint
Proven ability to lead cross-functional teams and manage complex projects

Nice To Haves

Certified Professional in Healthcare Quality Certification (CPHQ) or Lean background
Solid organizational, time management, and prioritization skills
Solid problem solving and analytical and skills
Excellent analytical, problem-solving, and communication skills
Ability to influence stakeholders at all levels and drive initiatives forward

Responsibilities

Develop and implement data-driven strategies to support quality and population health initiatives
Conduct data analysis to identify trends, gaps, and opportunities for improvement
Monitor and support quality improvement projects and incentive programs through performance tracking and outcome measurement
Ensure compliance with regulatory and state reporting requirements related to quality and population health
Prepare and deliver written and verbal reports and presentations to Health Plan Leadership and external stakeholders
Lead and delegate project tasks based on team members’ strengths, skill sets and experience levels
Engage directly with providers and other key stakeholders to support quality initiatives and foster collaboration
Influence and guide multidisciplinary teams, including external partners, on complex quality-related topics
Coordinate the development of presentations and data analysis for physicians, administrators, and community partners
Engage with ACO partners to develop expertise in value-based contracting and inform quality performance and potential for improvement
Support integration of internal processes and partners to support provider education in Quality Improvement
Support connection to community-based partners to support Medicaid priorities
Travel may be required to support community events and provider engagement