Quality Management Manager - Remote in Idaho

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.

Primary Responsibilities

• 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 insure 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
  
  

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

• 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
  
  

Preferred Qualifications

• 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
• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
  
  

The salary range for this role is $89,800 to $176,700 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

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.