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RN HEDIS Quality Manager - Orlando/JAX, FL $3,000 SIGN-ON BONUS - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Orlando, FL Orlando, Florida |
About this job
$3,000 SIGN-ON BONUS!
This position will oversee the Orlando and Jacksonville Markets.
The Quality Improvement Manager is responsible for coordinating and implementing the STAR's data collection and works in collaboration with the Director of Quality to develop strategies for achieving a 5 STAR rating. This role assists with data analysis and report preparation for all required data submissions. The Quality Improvement Manager provides direction and support to the various WellMed markets in the implementation of strategies for closing care gaps. . This role works closely and collaboratively with various functional areas of the delivery system to achieve the goals and objectives of the Quality Improvement Program.
Essential Job Functions
- Provides leadership and support in establishing the Quality Performance Initiatives at the market level.
- Collaborates with physicians to execute the implementation of the clinical quality initiatives as defined by enterprise.
- Provides expertise to the training department on STAR/HEDIS measures and on the tools that support the collection of STAR/HEDIS data.
- Work with IT on the interpretation of technical specifications and impact of HEDIS/STAR Measures to the data collection tools and reports utilized for the support of HEDIS/STAR measures.
- Conduct training on HEDIS/STAR measures, HEDIS/STAR data collection software and data collection strategies.
- Participate in NCQA HEDIS or Health Plan audits.
- Work with external vendors on data transmission issues.
- Analyze data for possible data integrity and data deficits.
- Analyze and trend HEDIS/STAR rates, identify barriers to improvement of rates and creating interpretive exhibits.
- Update QI Project templates and Work plan with assigned responsibilities.
- Attend and participate in all QI meetings.
- Performs all other related duties as assigned.
Requirements
- Registered Nurse with Undergraduate degree or equivalent experience
- 1 year HEDIS/STAR experience or participation with regulatory reporting.
- Five or more years of healthcare experience to include experience in a managed care setting.
- Three or more years of experience with data analysis.
- Must have a basic understanding of quality improvement standards such as NCQA, HEDIS, CAHPS, HOS and CMS
- Proven capability to work with people at all levels in an organization
- Excellent training and presentation skills with solid communication capabilities and practices, both oral and written.
- Demonstrated effective organizational skills.
- Excellent communication, writing, proofreading and grammar skills.
- Strong attention to detail and accuracy, excellent Evaluative and Analytical skills.
- Strong teamwork, interpersonal, verbal, written, and administrative and customer service skills.
- Advanced Experience using Microsoft office applications, including but not limited to databases, word-processing, spreadsheets, and graphical displays.
Preferred Education, Experience & Skills
- BSN degree or related field preferred.
- Three or more years of process management experience.
- Healthcare Quality Improvement experience.
- CPHQ Certification preferred
- CHCQM Certification preferred
WellMed is a healthcare delivery system serving more than 90,000 patients, primarily Medicare eligible seniors, in Texas and Florida through primary care clinics, multi-specialty clinics, and contracted medical management services. Headquartered in San Antonio, Texas, WellMed is an industry leader in medical risk management, highly effective disease management and chronic care programs, healthcare delivery services and more.
Our focus and mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. We are innovators in preventative healthcare, striving to change the face of healthcare delivery for seniors. Our providers and support staff are selected for their dedication to the senior population and focus on preventative, proactive patient care.
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(SM)
Diversity creates a healthier atmosphere: 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: WellMed, Optum, Healthcare, Quality Improvement, HEDIS, Stars, Orlando, Jacksonville, Manager, RN, Registered Nurse
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