RN Clinical Quality Analyst
UnitedHealth Group•Worcester, MA
•$60,200 - $107,400•Hybrid
About The Position
Opportunities with Reliant Medical Group, part of the Optum family of businesses. Join a community-based, multi-specialty, physician-led organization where you will work with talented peers on a common purpose: improving the quality, cost and experience of health care. Here, we focus on delivering the best patient care, rather than volume. Through innovation and superior care management, we support patients and your well-being as a team member. Join a team at the forefront of value-based care and discover the meaning behind Caring. Connecting. Growing together.
Requirements
- Graduate from an accredited school of Nursing and current licensure as a Registered Nurse in Massachusetts
- 5+ years nursing experience in a healthcare setting including hospital medical/surgical or ambulatory care
- Experience utilizing electronic medical records
- Knowledge of various software applications such as Microsoft PowerPoint, Excel, Access, Outlook, etc.
Nice To Haves
- Demonstrated experience in database management, statistical analysis, and graphics software
Responsibilities
- Participates in the Peer Review Program by performing quality case reviews submitted by risk management, incident reports, audits, sentinel events, clinician referrals or any complaints related to quality of care
- Utilizes critical thinking skills when interpreting and incorporating the organization’s policies and procedures to assess and evaluate case medical records, including chart review, provider feedback, and any previous reviews completed on the case to identify and address potential individual provider or operational process issues which impact the quality of care delivered at Reliant
- Utilizes critical thinking skills to determine appropriate patient outcome and care ratings based on review findings and communicate the conclusions to providers
- Participates with the development and correction of organizational system issue fixes to ensure compliance with legal and other external regulations/requirements to support the continuous performance improvement of the quality of care and service provided by the organization
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
