UnitedHealth Group-posted 10 months ago
$89,800 - $176,700/Yr
Full-time • Manager
Remote • Boise, ID
Insurance Carriers and Related Activities

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 Management Manager will monitor and support the health plan quality improvement initiatives with particular emphasis on HEDIS, NCQA, and State Performance measures. You'll act as a voice for our members, guiding the development of comprehensive care plans that will help others live healthier lives. If you are located in Idaho, you will have the flexibility to work remotely as you take on some tough challenges.

  • Oversee the implementation of plan's quality improvement program (QAPI)
  • Work to coordinate the work with the clinical, operations, and network teams to improve HEDIS and NCQA performance and to close gaps in care
  • Manage Quality work plan programs and activities
  • Collaborate across local and national business segments to achieve goals and targets
  • Develop and maintain positive relationships with external state organizations within the scope of Quality Management
  • Continuously monitor HEDIS, NCQA, and state performance measure results and adjust programs to ensure meeting targeted goals
  • Support Performance Improvement Projects, accreditation, and regulatory audits as needed
  • Develop and mentor quality department staff
  • Oversee quality quarterly review meetings with state partners
  • Experience with HEDIS and NCQA - this includes HEDIS and or NCQA project experience including audit and project management of the submissions to the state and NCQA
  • Quality Improvement project experience with quality improvement projects
  • Experience with outside audit organizations such as External Quality Review Organizations (EQROs)
  • Leadership experience (e.g., Review work of others, Serve as an expert in their field, Serve as a mentor and leader, Lead functional or segment teams or projects, Motivate and inspire team members)
  • Experience with managed care and insurance industry
  • Experience in writing reports and analyzing performance data
  • Experience creating detailed reports and project management
  • Experience with excel (working with pivot tables) and creating PPT presentations
  • Resident of Idaho
  • Current, unrestricted RN licensure in the state of Idaho
  • 2+ years demonstrated Management experience with responsibility for team performance management
  • Quality improvement experience within a health plan
  • Clinical experience / background
  • Change management experience and demonstrated skills
  • Proven ability to make independent decisions
  • Comprehensive benefits package
  • Incentive and recognition programs
  • Equity stock purchase
  • 401k contribution
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