National Director, Accreditation and Clinical Quality - Phoenix, AZ - Telecommute - Full-time / Part-time

Careers at UnitedHealth Group are anything but ordinary. We push ourselves and each other to find smarter solutions. The result is a culture of performance that's driving the health care industry forward. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Join us. And start doing your life's best work.(sm)
 
The National Director, Accreditation and Clinical Quality provides overall leadership to the Accreditation and Clinical Quality department  to successfully meet NCQA, URAC and other applicable accreditation requirements; state and federal requirements; and zero defects for internal and accreditation surveys/audits. You will oversee the development and day to day oversight of accreditation related aspects of the quality program; this includes proactive readiness assessment for surveys and audits; development, implementation and monitoring of corrective action plans; development of policies to support accreditation; production of reports and quality program documents; and working closely with external and internal business partners in planning for and executing compliance with accreditation and other accreditation related regulatory requirements.  You will manage all requirements and accreditation submissions across Commercial/Marketplace or Medicaid/Medicare for UHC. In addition, this position manages various Accreditation staff including Associate Directors, Accreditation Managers and Quality Consultants.  The National Director reports to the Senior Director, UnitedHealthcare Clinical Services (UCS) Regulatory Adherence and Accreditation and works closely with the respective Regional Quality leadership to align Accreditation with the organization’s overall quality strategy.
 
Primary Responsibilities:

Develops multi-year, cost effective strategies for successfully implementing an Accreditation strategy to meet the needs and requirements of each product line
Leads Accreditation and Clinical Quality department to achieve zero defects across our plans related to NCQA, URAC and other applicable regulatory/government requirements and applicable internal audits
Provides leadership in working with various internal and external business partners to meet compliance requirements for NCQA, URAC, and other state and federal regulatory requirements
Leads advocacy/relationship development with national partners/vendors including NCQA and URAC
Collaborates with senior national and regional leadership to identify opportunities for HEDIS/CAHPS focus, and to drive continuous improvement in accreditation status across all product lines
Provides direction in developing initiatives to meet accreditation/regulatory requirements and to achieve a continuous state of readiness and compliance
Achieves/exceeds established Accreditation annual goals and objectives established as part of the overall UCS and corporate goals & strategies
Monitors and reports on status and raises concerns regarding project issues, risks and deadlines with national and regional senior leadership
Check for gaps or risks identified in responses and contact the appropriate parties to coordinate State needs/requirements
Fosters innovative problem solving and upholds principles of continuous quality improvement (CQI).  Supports staff and workgroups in regularly identifying opportunities for improvement and innovation and implementing effective solutions
Works with Finance and UCS leadership in developing and managing annual Accreditation budgets
Effectively supports employee engagement and employee development
Other duties as assigned

Required Qualifications: 

A minimum of 10 years’ experience in quality improvement in a managed health care setting, with 5 of those in a leadership position
At least 10 years’ demonstrated experience in preparing NCQA or other accreditation surveys
5 years of experience directly managing staff
Bachelor’s degree in Nursing or other health care related field, Master’s degree preferred
CPHQ preferred
 Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can 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: Accreditation, Clinical Quality, NCQA, URAC, HEDIS/CAHPS, Commercial/Marketplace, Medicaid/Medicare, Arizona, Telecommute, AZ