13 days old

Manager, Clinical Quality - Telecommute in NC

Charlotte, NC 28202 Work Remotely
  • Job Code

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 Manager of Clinical Quality for NC oversees the implementation of health plan quality management program and is responsible for clinical quality in the areas of: NCQA accreditation and regulatory compliance, performance improvement, and quality program monitoring. The person in this role is expected to work directly with members of the care team to build relationships, ensure effective education and reporting, and to proactively identify performance improvement opportunities through analysis and discussion with subject matter experts.

This role will supervise a team of 3-5 of clinical quality staff working with the UHC Community Plan of North Carolina.

This role can be based out of the employee's home in North Carolina, but there is an expectation of some travel throughout North Carolina and in person meetings with the State and in the Raleigh office; with some trips requiring overnight stays.

If you are located in North Carolina, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:
  • Partners with Director of Quality and other health plan leaders to ensure Health Plan Quality Management /committee structure and integrated quality oversight processes are in place to carry out the Quality Management and Improvement Plan.
  • Leadership and supervisory responsibility for the UHC Community Plan of North Carolina
  • Clinical Quality program staff and the quality programs delivered by the plan.
  • Primary focus area: Partner with internal resources to ensure NCQA accreditation procedures and process are in place to ensure successful surveys.
  • Directs as applicable process improvement plans and corrective action plans for surveys, accreditations, EQROs, and state audits, within the scope of Quality Management and Improvement.
  • Ensure providers understand incentive opportunities and receive ongoing feedback and report cards designed to motivate and optimize provider incentive payouts.
  • Support larger regional and market team by sharing expertise and serving as a touch point/SME for contracting and account management questions.
  • Evaluate and provide feedback to improve performance of provider support personnel, inclusive of clinical and non-clinical personnel

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.



Posted: 2020-10-06 Expires: 2020-11-05

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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Manager, Clinical Quality - Telecommute in NC

UnitedHealth Group
Charlotte, NC 28202

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