Director of Quality HEDIS

Company: UnitedHealth Group
Location: Fort Worth
Posted on: February 25, 2021

Job Description:

Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM Do you have compassion and a passion to help others?--Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve--your life's best work.(sm)-- The--Director of Quality/HEDIS--is responsible for coordinating and implementing quality initiatives designed by enterprise/OHCC to continuously improve all aspects of health care delivery. This includes communication and monitoring of initiatives as well as promoting culture changes that support an environment of quality. This position is also responsible for coordinating and implementing HEDIS, CAHPS and HOS projects and assisting with data analysis and report preparation for Regional Success Collaborative as well as OHCC. The Director works closely and collaboratively with various functional areas of the delivery system and OHCC to achieve the goals and objectives of the QI/HEDIS program. Primary Responsibilities:

• Provides leadership and support in establishing and directing the Quality Program consistent with the delivery system/OHCC directives
• Develops and/or maintains policies and procedures that support the corporate initiatives that meet State, Federal legal requirements and standards
• Collaborates with physicians to execute the implementation of the clinical quality data initiatives as defined by enterprise and/or OHCC
• Provides expertise to the training department on HEDIS measures and tools that support collection of and communication about HEDIS to the enterprise
• Works with Enterprise on developing and implementing HEDIS member engagement strategies
• Works with OHCC leadership to provide information or data as requested
• Facilitates, integrates, and/or coordinates the implementation and evaluation of identified quality improvement/HEDIS activities as requested by UHG or related companies
• Promotes understanding, communication and coordination of all quality improvement program components
• Participates in requested evaluations and audits
• Coordinates reporting on quality initiatives to all appropriate committees
• Assists with the development of the QM and UM Work Plan, Evaluation and the monitoring of Work Plan activities as they relate to PI
• Develops operating budget as necessary
• Participates in various teams, committees and meetings at any level required to maintain business necessity
• Maintains QI program documents, reports, and committee minutes and follows all internal privacy and confidentiality policies and procedures
• Maintains current knowledge of regulatory requirements associated with the QI program
• Oversees HEDIS data submission process
• Leads accreditation efforts as defined by enterprise
• Performs all other related duties as assigned This is an office based position in Fort Worth TX You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.-- Required Qualifications:
  • Bachelor's degree in Registered Nursing or related field
  • 8+ years of experience in quality improvement in a managed care environment and/or large physician practice setting, including three or more years of management experience
  • Basic understanding of quality improvement standards such as NCQA, HEDIS, CAHPS, HOS and CMS
  • Established and managed an annual budget
  • Proficient knowledge of Microsoft Office applications required, including, but not limited to, Word, Excel, Access, and PowerPoint
  • You will be asked to perform this role in an office setting or other company location
  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained Preferred Qualification:
    • Master's Degree--(MBA, MHA, MPH, MN or related field) Careers with WellMed.--Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do--your life's best work.(sm) **PLEASE NOTE** --The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time, or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus.
      Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
      UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: Director, Quality Improvement, Fort Worth, TX, Texas, HEDIS,NCQA, Managed Care, CMS, Process Improvemet, STARS, QI, healthcare, Medicare Advantage, healthplan, fort worth-- Our team members help close the gap in health care. Take a closer look and see how Lisa helps members navigate a complex health care system. We're committed to diversity and inclusion in everything we do. It's ultimately what helps us understand a variety of perspectives and provide quality care to our diverse member population. If you're interested in working for an organization that val--- A Nursing career at UnitedHealth Group can be challenging, yet very rewarding at the same time. Our Registered Nurses and Nurse Practitioners are caregivers through and through. At UnitedHealth Group, they work in a fast-paced environment directly wi--- At UnitedHealth Group we utilize many avenues to find the right candidates to fill open positions. One of which, involves asking our current employees to refer the people they know that would be a good fit for the company. Our employees have great in--- UnitedHealth Group is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or accommodation for any part of the application process, please call 1-800-561-0861 and press or say 1 for Applicant to be connected to Recruitment Services. Recruitment Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through Friday. UnitedHealth Group is a registered service mark of UnitedHealth Group, Inc. The UnitedHealth Group name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the UnitedHealth Group, Inc. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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