Quality Improvement Lead - Remote in Northern Lower and Thumb Area, Michigan

UnitedHealth Group•Midland, MI

10d•Remote

About The Position

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 (QI) Lead supports our mission to help people live healthier lives by leading population-focused initiatives aimed at improving health outcomes, as measured by HEDIS and other key quality metrics. This role manages new and ongoing projects, implementing members, providers, and system-level interventions to close care gaps. Working in a highly collaborative environment, the QI Lead partners across functions such as Clinical, Provider Engagement, Member Experience, Compliance, and Pharmacy to drive continuous quality improvement aligned with organizational goals. If you are located in Michigan, you will have the flexibility to work remotely as you take on some tough challenges.

Requirements

Active and unrestricted RN license in the state of Michigan
3+ years of experience working on programs for patients/members with complex care needs, including chronic conditions and/or behavioral health conditions
3+ years of experience in quality improvement, managed care, or healthcare administration, including work with complex care populations (e.g., chronic or behavioral health conditions)
Experience with Medicaid, LTSS and/or D-SNP programs
Proven solid project and data management skills, including experience working with multiple databases and analyzing healthcare data
Proven ability to develop and deliver presentations to internal and external stakeholders using virtual platforms (e.g., Microsoft Teams, WebEx/Zoom)
Experience engaging with providers and community partners across specialties to support quality initiatives
Experience in reviewing literature and stakeholder feedback to inform program development and improvement
Intermediate proficiency in Microsoft Office Suite, like Excel, PowerPoint, Word, and Outlook
Driver's License and access to reliable transportation
Resident of Michigan

Nice To Haves

Certified Professional in Healthcare Quality (CPHQ)
Experience in managed care organizations, including oversight of NCQA, HEDIS, and/or STARS measures
Solid knowledge of HEDIS, NCQA standards, regulatory requirements, and the managed care industry
Familiarity with Health Information Exchanges (HIEs), Electronic Medical Records (EMRs), and practice management systems
Experience leading cross-functional teams and implementing health education or quality improvement programs
Proven ability to analyze managed care contracts and apply insights to program development
Solid communication skills with the ability to engage stakeholders at all levels
Demonstrated adaptability and problem solving skills in fast-paced, matrixed environments

Responsibilities

Lead and coordinate quality improvement initiatives to enhance health outcomes and meet HEDIS, STARS, and other key performance metrics
Manage projects aligned with regulatory, accreditation, and business requirements, ensuring compliance and continuous performance improvement
Develop and implement health education and promotion programs to support member engagement and access to care
Identify and address barriers to care through data analysis, literature review, stakeholder feedback, and community engagement
Collaborate across departments (e.g., Clinical, Provider Engagement, Pharmacy) to align interventions with population health goals
Monitor and report on performance trends; support audits, contractual reporting, and quality-related committees
Facilitate Performance Improvement Projects (PIPs) and contribute to documentation such as Trilogy Documents, Population Health Plans, and Committee presentations
Engage with community partners and providers to support care coordination, offer training, and drive provider-level quality improvement
Serve as a clinical subject matter expert to internal teams, leadership, and external stakeholders
Support special projects and manage program implementations as assigned