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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 in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.
This position works under the supervision of the Director of Clinical Quality Management (CQM). Oversees the management of patient safety activities, including quality investigations, tracking and trending of quality issues, provider corrective actions, completeness of processes and case review meetings. This individual will be responsible for ensuring all appropriate entities are timely notified of potential and confirmed patient safety issues. Responsible to manage a clinical team of CQM Patient Safety Specialists. The position will contribute to the annual CQM plan, attend committees, and ensure deliverable submission. This individual will be part of the start-up team for Optum’s Veterans Administration Community Care Network (VA CCN) and will assist with other start up CQM activities.
Primary Responsibilities:
- Initially, is responsible to work with the leadership team in the design, development and start-up activities associated in standing up the business to operate the VA CCN program
- Provides day-to-day supervision of the CQM Patient Safety Specialists to ensure the potential quality issue investigation process is completed through timely closure
- Ensure quality issue investigations meet contractual turnaround time requirements
- Performs team mentoring, goal setting and performance evaluations
- Prepares development plans and performance evaluations
- Reviews and assigns cases appropriately to match staff skill level
- Develops and maintains CQM training modules, policies and procedures, work instructions, other training/guide tools and performs training sessions on relevant subject matter
- Provides reports, facilitates case review meetings, participate in quality improvement projects, request and analyzes data queries
- Assist with preparation of cases for peer review activities and quality committees
- Track timeframes/deadlines and collect data to ensure required timeframes are met and communicate potential barriers or risks
- Performs audits to ensure quality of case reviews are performed accurately and consistently by each reviewer
- Work cross-functionally and coordinate with other key stakeholders internally or externally
- Analyze and interpret clinical and administrative data to ensure they meet standards and provide rationale
- Manage or actively participate in meetings
- Serve as a resource providing explanations and expertise providing information to others regarding potential quality issues and the CQM investigation process
- Other duties as assigned
Working Conditions:
- Remote considered
- Minimal travel
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:
- RN with current, active license without restriction in required state(s)
- 3+ years of clinical experience
- 2+ years of supervisory/management experience
- 2+ years of direct clinical quality experience
Preferred Qualifications:
- Bachelor of Science in Nursing (BSN)
- Certified Professional in Healthcare Quality® (CPHQ) or patient safety (CPPS)
- Government program experience (TRICARE and/or VA)
- Acute care patient safety/quality experience (i.e., event reviews, RCA, Medical Peer Review)
Knowledge, Skills and Abilities:
- Knowledge of accreditation activities
- Excellent interpersonal, communication, and writing skills
- Detail oriented with solid organization, multitasking and time management abilities
- Solid time management skills and broad base of clinical knowledge /experience
- Moderate to Advanced computer skills with emphasis on Microsoft Office software (Word, Excel, Access, PowerPoint)
- New clinical business start-up experience that includes program design, hiring staff, policy and procedure development, staff training, and system design and testing
- Knowledge of clinical standards of care and practice guidelines
- Prior oversight of KPIs, performance, contractual metrics
- Prior analytical quality/safety analysis
- People leader management experience
Location:
- Eden Prairie, telecommuting will be considered
- Must live in a location that can receive a high speed internet connection using a UHG approved Internet Service Provider (ISP) or be within a 2 hour driving distance of a UHG office with hoteling
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 – $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.
UnitedHealth Group and its affiliated brands are 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 and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
