Senior Clinical Quality Analyst

UnitedHealth Group•Tampa, FL

2h•$72,800 - $130,000•Remote

About The Position

The Senior Clinical Quality Analyst is responsible for developing and implementing an annual accreditation preparedness plan that meets or exceeds URAC, ACHC, and NABP requirements across pharmacy and wholesale locations. The role partners with Pharmacy Operations, distribution, licensing, business leads, and subject matter experts to maintain readiness, improve quality, and support continuous compliance with regulatory, accreditation, and contractual requirements. The position uses Personal Health Information (PHI) and contributes to operational conformance, streamlined processes, and continuous quality improvement. This is a full-time, national remote position within the United States. The employee must be flexible to work schedules during normal business hours of 8 a.m. to 5 p.m., Monday through Friday; occasional overtime may be necessary. The position includes on-the-job training during normal business hours and may require domestic travel up to 25%, including travel by plane or car with minimal notice. Remote employees must maintain a secure, private work area and an approved high-speed internet connection, and must comply with UnitedHealth Group’s Telecommuter Policy.

Requirements

High school diploma or GED.
Must be at least 18 years old.
At least 3 years of experience in quality auditing, healthcare compliance, pharmacy operations, or pharmacy fulfillment.
Proficiency in Microsoft Excel, Word, and PowerPoint.
Ability to travel domestically up to 25% of the time, including by plane or car with minimal notice.
Valid driver's license.
Ability to work full time Monday through Friday and flexibly during normal business hours of 8 a.m. to 5 p.m.; occasional overtime may be necessary.
Ability to secure sensitive company documents and maintain a dedicated work area separated from other living areas to protect information privacy.
Must live in a location that can receive a UnitedHealth Group-approved high-speed internet connection or have existing high-speed internet service.
Strong interpersonal skills, including positive assertiveness, professional communication, relationship building, and effective written and verbal communication.
Remote employees must adhere to UnitedHealth Group’s Telecommuter Policy.

Nice To Haves

Experience in a managed care setting with responsibility for quality management or regulatory compliance.
Project management experience.
Experience interpreting federal and state regulatory or accreditation requirements.
Certified Professional in Healthcare Quality (CPHQ) credential or another auditor program.
Experience collaborating with external clients and stakeholders.

Responsibilities

Support online ACHC applications, maintenance attestations, and organizational change notifications.
Coordinate with business leads and subject matter experts to obtain required evidence and assess it for ACHC completeness.
Prepare for ACHC surveys through readiness reviews, mock surveys, operational walkthroughs, record sampling, document validation, and staff preparation.
Translate ACHC standards into standards-to-evidence trackers and develop and manage readiness plans, project timelines, gap analyses, policy assessments, dashboards, and other compliance tools.
Identify quality risks and communicate potential barriers to functional areas; assist with action plans addressing risks, gaps, root causes, and barriers.
Work with business-segment leaders and staff to support continuous accreditation compliance.
Develop and maintain training modules and staff education for ACHC-accredited areas.
Serve as a subject matter expert in developing and documenting Quality Improvement Projects (QIPs), Corrective Action Plans (CAPs), and Quality Improvement Activities (QIAs) for ACHC and other accrediting bodies.
Prepare for, facilitate, and attend ACHC onsite or virtual accreditation surveys and onsite monitoring visits; coordinate responses to findings and plans of correction.
Interpret and operationalize ACHC standards and applicable requirements, and communicate standard updates and their business impact.
Support other accreditation onsite audits, including URAC and NABP, as applicable.
Educate, motivate, and influence leaders, stakeholders, and others to understand the process, overcome barriers, and participate in and commit to it.