Senior Clinical Quality Analyst-Philadelphia Based or Telecommute!

The primary responsibility of this Senior Clinical Quality Analyst is to conduct clinical quality auditing of clinical operations staff. Have the ability to navigate authorization and call recording systems. Will also need to provide feedback and discuss evaluations with staff. Will need to be able to analyze quality results and provide recommendations for quality improvement. May also handle quality of care complaints and conduct analyses for annual evaluations.
We're looking for a self-motivated healthcare professional with Behavioral Healthcare Quality Improvement (QI) experience.
 
Primary Responsibilities:

Conduct clinical quality audits
Coordinates review and the investigation of potential quality of care complaints
Monitors key performance indicators
Oversees interventions / data analysis of assigned ongoing quality improvement activities (QIAs), including possible initiation of individual workgroups for QIA improvement
Maintains strong positive relationships with customers and other UBH departments
Gathers and analyzes data
Creates reports and annual core documents for customers
Ensures compliance with relevant accreditation standards, which includes creating analysis and summary documents of various projects for accreditation organizations (NCQA, URAC)
Facilitating and coordinating quality improvement committee meetings Preparing for audits

Required Qualifications:

Master’s degree with independent licensure in the Mental Health field such as: PhD, LCSW, LMFT/MFT, LPCC or RN license with experience in mental health
2+  years of experience working in behavioral health
Excellent oral and written communication skills including expertise in writing reports and business letters
Excellent analytic skills including ability to clearly articulate issues and business needs
Ability to work collaboratively with individuals at all levels throughout the organization
Excellent problem solving and organizational skills
Computer proficiency
Preferred Qualifications:

Experience in behavioral health quality improvement
Experience with NCQA and HEDIS
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: 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. 
 
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 
 
Job Keywords: Clinical Quality Analyst, NCQA, HEDIS, Behavioral Health, Philadelphia, PA, Pennsylvania, Boston, MA, Massachusetts,Telecommute, telecommuter, telecommuting, remote, WFH