11 days old

Associate Director of Clinical Quality - Telecommute Omaha, NE

Omaha, NE 68102 Work Remotely
  • Job Code
    878803

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 and help people live healthier lives while doing your life's best work.(sm)


The Associate Director of Clinical Quality provides strategic leadership and direction for the quality improvement and management program(s) as a core service to Community & State Plans. The Director works within highly matrixed relationships to lead and develop the overall quality strategy for the plan, insuring the quality program is proactive, continuously improving, applies to all product and programs within the state, and includes both quality management/regulatory adherence and quality improvement.


If you are located within commutable distance from Omaha or Lincoln NE, you will have the flexibility to telecommute* as you take on some tough challenges.


Primary Responsibilities:

  • Oversee the development and implementation of plan quality program including creating strategic partnerships with internal and external stakeholders to ensure a holistic and comprehensive quality program
  • Own the end to end process
  • Coordinate the work across HEDIS Operations, Data Analytics and Reporting, Accreditation, Member Surveys, Regulatory Adherence, Member Engagement, Medical Quality Applications, and other matrix partners; utilizing the expertise, standard process, and capabilities of these areas to enhance quality program performance of the plan
  • Create a comprehensive Quality Improvement plan, playbook and quality targets that link to contractual and regulatory obligations, value based contracting and other HP identified initiatives
  • Oversee and direct as applicable quality improvement activities and interventions; and manage committees related to the quality programs such as the Quality Assurance Performance Improvement Committee
  • Manage and own the implementation of initiatives that support achievement of the Medicaid Agencies Quality Performance Program Measures to receive full financial returns
  • Ensure strong HEDIS performance
  • Cultivate a strong working relationship across business segments to attain or maintain the Plan's compliance with accreditation standards and contractual requirements as they apply to quality
  • Develop and maintain positive relationships with Medicaid and Long Term Care, stakeholders, community organizations and the External Quality Review Organization (EQRO) within the scope of Quality Management and Improvement
  • Ownership of Performance Improvement Projects as developed by EQRO
  • Oversee and insure the completion, integration, maintenance, approval, and submission of the trilogy document; including but not limited to Quality Program Description, Work Plan, Evaluation, and Program Policies and Procedures
  • Provide, through partnership with the Chief Medical Officer, strong leadership for the local quality team and integration with the Nebraska C&S clinical organization to meet the overall strategic quality goals of the HP


This role is a member of the Health Plan's senior leadership and works closely with the CEO, Chief Medical Officer, Operations (COO), Finance (CFO), Product leader for Dual Special Needs Plans, Marketing and Communications, Network Leadership, Health Services and Compliance.


Preference will be given to candidates who are able to work in the Omaha, NE office. Candidates who live in Central or Eastern Nebraska and are willing to telecommute and travel to Omaha or Lincoln as needed for meetings, will also be considered. The person that fills this position must reside in the state of Nebraska.


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.

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Posted: 2020-06-24 Expires: 2020-07-29

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Associate Director of Clinical Quality - Telecommute Omaha, NE

UnitedHealth Group
Omaha, NE 68102

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