Job Description

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

The Quality Coordinator is responsible for the facilitation, implementation and coordination of the quality improvement and management program, including NCQA accreditation and HEDIS improvements.

This position must reside within a commutable distance of the Louisville, KY office. You will work in the office as needed and have the flexibility to telecommute* the rest of the time.

Primary Responsibilities:

* Develop and prepare documentation for NCQA and other accreditation surveys submissions
* Provide annual evaluation of program design and efficacy as well as development of work plans to address performance improvement
* Collaborate with multiple functions that may include Clinical, Physician Engagement, Member Experience, Benefit Design / Product, Compliance, Network, Behavioral Services, and Pharmacy as needed to drive the quality improvement program
* Initiate program improvement projects and activities to drive outcomes
* Implement policies and procedures to align with program goals and compliance requirements
* Represent the health plan and provide subject matter expertise at internal clinical and quality meetings, regulatory meetings, and any relevant community partner meetings, workgroups, etc.
* Monitor and oversee execution of performance and activities to improve health and quality outcomes and effective medical management (e.g., HEDIS, CAHPS)
* Participate in or coordinate with other department projects as needed
* May do additional duties as assigned

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:

* 3+ years of experience in the healthcare industry
* 1+ years of experience with demonstrated functional knowledge of process improvement, quality improvement, and change management
* Excellent writing skills
* Proficiency with Microsoft Office Suite to include Word, Outlook and Excel
* Research experience
* Excellent verbal communication
* If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:

* Bachelor's degree
* Knowledgeable of the managed care / health insurance industry, products and services
* Quality knowledge of HEDIS, CAHPS

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

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.

Job Keywords: Quality Coordinator, HEDIS ACHPS, Health Insurance, Healthcare, Managed Care, Quality Improvement, Change Management, Telecommute, Telecommuting, Telecommuter, Work From Home, Remote, Louisville, KY, Kentucky