Overview
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.
Primary Responsibilities
Develop and implement data-driven strategies to support quality improvement initiatives
Maintain and enhance reporting systems for HEDIS, Stars, CAHPS, and other regulatory and internal quality metrics
Conduct data analysis to identify trends, gaps, and opportunities for improvement
Support quality improvement projects with data analysis, performance tracking, and outcome measurement
Manage all Quality Committees under the UnitedHealthcare Community Plan Hawaii umbrella to assure that QM Committee activities are fulfilled, on track and recorded
Serve as a liaison with national Quality Committees to communicate back information to the local plan as needed
Support quality management documents such as the Quality Improvement Program Description, Quality Improvement Work Plan and the Quality Improvement Program Evaluation, ensuring timely completion and approval
Ensure evaluations are written and updated as required to fulfill requirements of UHC national QMP, NCQA and State regulations
Manage existing QMP policies and procedures, write new policies, align them to regulatory requirements and accreditation crosswalks, and maintain ongoing regulatory and accreditation readiness
Provide project management oversight for activities related to HEDIS, CAHPS, PIPs, and other projects as assigned
Conduct performance improvement projects and complete submission of necessary reports
Participate in quality-related audits (e.g., EQRO, HEDIS) and ensure QMP requirements under the audit are met
Manage quality-related reports as required by State, NCQA, etc.
Prepare effectiveness studies on program activities to identify improved outcomes and status of meeting set objectives
Other duties as assigned
Minimum Qualifications
3+ years of experience in the health care field with a focus on healthcare data analysis and quality improvement
Experience with data visualization platforms (e.g., Tableau, Power BI)
Experience with MS Word, Excel, PowerPoint, Outlook
Solid understanding of HEDIS, Stars, CAHPS and other healthcare quality metrics
Demonstrated excellent communication and project management skills
Ability to travel about 10% of the time on Oahu, HI
Preferred Qualifications
1+ years of experience with HEDIS, Stars, CAHPS and other healthcare quality metrics
1+ years of experience working in health plan or other setting in quality management
Knowledge of regulatory agencies including NCQA
Remote work and travel All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Travel to Honolulu office for meetings, offsite Quality Committee meetings, and State-sponsored meetings may be required up to 10 percent of the time.
Compensation and benefits Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to salary, we offer a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable. #UHCPJ
Equal Opportunity UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.