Senior Clinical Quality Nursing Specialist
3 days ago
We are seeking an experienced Senior Clinical Quality Nursing Specialist to join our team at UnitedHealthcare. In this role, you will play a critical part in improving the quality of care provided to our members.
As a Senior Clinical Quality Nursing Specialist, you will be responsible for analyzing member care data and trending quality compliance at the provider level. You will also develop action plans and programs to support provider practices in continuous quality improvement using approved clinical practice guidelines, HEDIS, CMS, NCQA, and other tools.
About UsAt UnitedHealthcare, we're committed to simplifying the healthcare experience and creating healthier communities. We believe that everyone deserves access to high-quality, affordable healthcare, and we're working tirelessly to make that a reality.
What You'll Do- Analyze member care data to identify trends and areas for improvement
- Develop and implement action plans to support provider practices in continuous quality improvement
- Work with providers to ensure compliance with quality metrics and standards
- Participate in community-based organization events, clinic days, health department meetings, and other outreach events focused on quality improvement and member health education
To be successful in this role, you will need:
- A current unrestricted RN licensure in the state of Kansas
- At least 2 years of clinical experience as an RN
- At least 2 years of experience with quality improvement
- Intermediate level of proficiency in MS Office, including Word, Excel, and Outlook
- Access to reliable transportation and the ability to travel up to 75% of the time to providers
- Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI)
We offer a competitive salary of $85,000 - $110,000 per year, depending on experience, plus a range of benefits, including:
- Paid Time Off
- Medical Plan options along with participation in a Health Spending Account or a Health Savings account
- Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage
- 401(k) Savings Plan, Employee Stock Purchase Plan
- Education Reimbursement
- Employee Discounts
- Employee Assistance Program
- Employee Referral Bonus Program
- Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
UnitedHealthcare is a leading health insurance company that provides a range of products and services to individuals, employers, and governments. We are committed to simplifying the healthcare experience and creating healthier communities through our innovative solutions and compassionate care.
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