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Hours Full-time, Part-time
Location Brentwood, TN
Brentwood, Tennessee

About this job

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) AmeriChoice is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.     If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at AmeriChoice.     We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.     This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.     Purpose of Job:      The Clinical Quality Analyst RN receives and investigates all critical incident and potential quality of care concerns, compiles and maintains report data in a standard format to support LTC Choices.  This position is responsible for timely submissions to the Bureau of TennCare for the Critical Incidents surrounding the CHOICES amendment to the TennCare CRA.  This individual will track and trend information to assist in the application and interpretation of data to drive quality improvement efforts.      Primary Responsibilities:   Implement and maintain data bases necessary to complete standard quality reports and analysis within agreed upon deadlines surrounding the CHOICES, Long Term Care, populationComplete ad hoc reports as requestedRoutinely analyze results of quality reviews to report error trendsManage assigned special projects to completion within target dateCreate Quality system tools/databases to capture relevant dataUse creativity to solve problemsDemonstrate leadership in continuous improvementUtilize change management to drive resultsDevelop recommendations for quality remediation plansShare best practices and support team goals and objectivesDrive consistency and efficient processes on the teamActively participate in quality improvement initiatives/meetingsResponsible for maintaining and increasing self-proficiency in the use of quality tools and methods and the application of quality scienceInterface with many internal clinical staff and external providers to gather critical incidents information for quick turn-a-round state reporting to avoid liquidated damages You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.   

Requirements

Required Qualifications:      Valid, unrestricted RN license in the state of TN, or the ability to obtain through reciprocity3 + years' clinical experience resulting in strong clinical judgmentSolid experience in tracking and trending dataStrong computer skills including the ability to create and manipulate Excel spreadsheets Desired Qualifications:      BSN or higher degreeExperience in a Long Term Care environmentMedical record review experienceKnowledge of health care products, delivery systems, claims processing and supporting systemsKnowledge of quality improvement methods and tools (SPC, Six Sigma)Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place 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: RN, Registered Nurse, Clinical experience, Brentwood, TN, Tennessee