Director of Quality HEDIS Dallas TX (875598)

    UnitedHealth Group Inc.
    Dallas, TX
    Similar jobs pay $7.87 - $11.62

    Job Description

    Position Description
    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)

    The Director of Quality/HEDIS is responsible for coordinating and implementing quality initiatives designed by enterprise/OHCC to continuously improve all aspects of health care delivery. This includes communication and monitoring of initiatives as well as promoting culture changes that support an environment of quality. This position is also responsible for coordinating and implementing HEDIS, CAHPS and HOS projects and assisting with data analysis and report preparation for Regional Success Collaborative as well as OHCC. The Director works closely and collaboratively with various functional areas of the delivery system and OHCC to achieve the goals and objectives of the QI/HEDIS program.

    Primary Responsibilities:
    • 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
    You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

    Required Qualifications:
    • Bachelor's degree in Registered Nursing or related field
    • 8+ 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
    • Basic understanding of quality improvement standards such as NCQA, HEDIS, CAHPS, HOS and CMS
    • Established and managed an annual budget
    • Proficient knowledge of Microsoft Office applications required, including, but not limited to, Word, Excel, Access, and PowerPoint
    Preferred Qualification:
    • Master's Degree (MBA, MHA, MPH, MN or related field)
    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 240,000+ 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: 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: Director, Quality Improvement, Dallas, TX, Texas, HEDIS,NCQA, Managed Care

    Posting ID: 558253823Posted: 2020-05-21