Senior Clinical Quality RN - Hybrid East Valley

UnitedHealth Group; Phoenix (AZ); Hybrid; Confidential; Full time

Job summary

An innovative healthcare company is seeking a Sr. Clinical Quality Consultant RN to enhance quality performance and drive improvements in healthcare delivery. This role offers a unique opportunity to work in a hybrid environment, balancing time between home and the office. You'll collaborate with provider groups to implement effective strategies, analyze performance metrics, and lead quality improvement initiatives. With a commitment to equity and health disparities, this organization values your contributions and offers a supportive environment for professional growth. Join a team dedicated to making a meaningful impact in healthcare.

Benefits

Comprehensive Benefits Packages

Incentive Programs

Stock Purchase Options

401k Contributions

Qualifications

• 4+ years of healthcare experience with a focus on quality improvement.
• Registered Nurse with experience in provider-facing roles.

Responsibilities

• Drive improvements in STAR measure performance through business plans.
• Analyze provider operations to identify performance strategies.

Skills

Healthcare Experience

Provider-Facing Interactions

Microsoft Office Proficiency

Analytical Skills

Education

Registered Nurse License

Post-High School Education

Tools

Microsoft Office

Job description

Position Overview

***Position is Hybrid and based in Phoenix ***

(Time spent in the field, working from home, and occasionally in the office for meetings or training)

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

The Sr. Clinical Quality Consultant RN will drive consistency, efficient processes, and share best practices in collaboration with provider groups, aiming to facilitate a minimum 4 STAR quality performance.

The Sr CQC will participate in quality improvement initiatives, attend meetings, develop remediation plans, and create tools and databases for data capture. This role collaborates with regional teams and may serve as a team lead, responsible for the network’s quality performance.

If located in Phoenix, AZ, you will have the flexibility to work from home and in the office in this hybrid role.

Primary Responsibilities

• Develop business plans to motivate providers to improve STAR measure performance
• Provide analytical summaries of STAR/HEDIS performance to provider groups
• Serve as the subject matter expert for all STAR-related activities in the assigned territory
• Participate and present in regular performance review meetings
• Analyze provider structure and operations to identify strategies for performance improvement
• Assist in developing presentation materials for provider meetings

You’ll be rewarded and recognized for your performance in an environment that challenges you and provides development opportunities.

One year of post-high school education can substitute for one year of experience.

Required Qualifications

• Registered Nurse (AZ and/or a compact state)
• 4+ years of healthcare experience
• 2+ years of provider-facing interactions
• Proficiency in Microsoft Office applications
• Ability to travel locally 50%
• Driver’s license and reliable transportation

Preferred Qualifications

• 2+ years in HEDIS/STARS, preferably in a clinical quality role
• Experience in clinical data abstraction and chart review
• Billing and CPT coding experience
• Medicare or managed care experience

The salary range is $71,600 to $140,600 annually, based on full-time employment and factors like experience, education, and location. Benefits include comprehensive packages, incentive programs, stock purchase options, and 401k contributions.

At UnitedHealth Group, our mission is to help people live healthier lives and improve the health system. We are committed to equity and addressing health disparities.

OptumCare is an Equal Opportunity Employer. Candidates must pass a drug test before employment.