DSNP RN Clinical Quality Specialist

4 weeks ago


Tucson, Arizona, United States UnitedHealth Group Full time

Transforming Healthcare Together

At UnitedHealth Group, we're committed to simplifying the healthcare experience and creating healthier communities. As a DSNP RN Clinical Quality Specialist, you'll play a vital role in removing barriers to quality care and making a meaningful impact on the lives of millions.

Key Responsibilities:

  • Close care gaps through telephonic and follow-up with members
  • Provider outreach to address care gaps, utilizing various communication channels
  • Chart upload in Practice Assist to close care gaps
  • Support HEDIS chart chase efforts by retrieving medical records from providers
  • Contribute to STARS improvement projects, HEDIS, and CAHPS measures, providing clinical guidance
  • Collaborate with Health Plans as a Subject Matter Expert on STARS and HEDIS Technical Specifications, project plans, and reporting logistics
  • Identify and implement opportunities to improve data collection efficiency
  • Support National Team efforts and educate providers on general policies and procedures
  • Engage providers to introduce new initiatives and monitor their success

Requirements:

  • Registered Nurse with no restrictions in state required to practice
  • 3+ years of experience working in a healthcare environment
  • 3+ years of experience in project management, data analysis, and tracking
  • 2+ years of experience in Medicare, DSNP Lines of business
  • 2+ years of experience in Stars, HEDIS measure technical specifications
  • Intermediate or higher level of proficiency with Excel and PowerPoint

Preferred Qualifications:

  • UnitedHealth Group, Optum, or UnitedHealthcare experience
  • Community & State and or Medicare & Retirement experience
  • Demonstrated ability to communicate ideas clearly and concisely
  • Flexibility and quick adaptation to change

About UnitedHealth Group:

We believe everyone deserves the opportunity to live their healthiest life. Our mission is to help people live healthier lives and make the health system work better for everyone. We're committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes.

Equal Employment Opportunity:

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.


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