Director of Quality Improvement - San Antonio, TX - Full-time / Part-time

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 and help people live healthier lives while doing your life's best work.(sm)

• Provides leadership and support in establishing and directing the Quality Program consistent with the delivery system/OHCC directives


• Develops and/or maintains policies and procedures that support the corporate initiatives that meet State, Federal legal requirements and standards


• Collaborates with physicians to execute the implementation of the clinical quality data initiatives as defined by enterprise and/or OHCC


• Provides expertise to the training department on HEDIS measures and tools that support collection of and communication about HEDIS to the enterprise


• Works with Enterprise on developing and implementing HEDIS member engagement strategies.


• Works with OHCC leadership to provide information or data as requested


• Facilitates, integrates, and/or coordinates the implementation and evaluation of identified quality improvement/HEDIS activities as requested by UHG or related companies


• Promotes understanding, communication and coordination of all quality improvement program components


• Participates in requested evaluations and audits


• Coordinates reporting on quality initiatives to all appropriate committees


• Assists with the development of the QM and UM Work Plan, Evaluation and the monitoring of Work Plan activities as they relate to PI


• Develops operating budget as necessary


• Participates in various teams, committees and meetings at any level required to maintain business necessity


• Maintains QI program documents, reports, and committee minutes and follows all internal privacy and confidentiality policies and procedures


• Maintains current knowledge of regulatory requirements associated with the QI program.


• Oversees HEDIS data submission process


• Leads accreditation efforts as defined by enterprise


• Performs all other related duties as assigned

• Bachelor's degree in Registered Nursing or related field required


• Eight or more years of experience in quality improvement in a managed care environment and/or large physician practice setting, including three or more years of management experience


• 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


• Strong interpersonal, verbal, written, and administrative skills


• Established and managed an annual budget


• Proficient knowledge of Microsoft Office applications required, including, but not limited to, Word, Excel, Access, and PowerPoint


• 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 and customer service skills

•  Masters (MBA, MHA, MPH, MN or related field)

• Ability to lift up to 25 pounds


• Ability to push or pull heavy objects using up to 25 pounds of force


• Ability to sit for extended periods of time


• Ability to receive and comprehend instructions verbally and/or in writing


• Ability to use logical reasoning for simple and complex problem solving

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 90,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team 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. Certain positions are subject to random drug testing.

Job Keywords: Director, Management, Manager, Quality Improvement, San Antonio, TX, Texas