Clinical Quality Analyst - LTSS - Telecommute in TN

Company: UnitedHealth Group
Location: Brentwood
Posted on: May 16, 2022

Job Description:

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing -your life's best work.(sm)The Clinical Quality Analyst receives and investigates all reportable events, including potential quality of care and quality of services concerns; compiles and maintains report data in a standard format to support the Managed Long Term Services and Supports (MLTSS) Program. - This position is responsible for timely submissions to the Bureau of TennCare and the Tennessee Department of Intellectual and Developmental Disability for reportable events surrounding the 14th 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. - - -If you are located in Tennessee, you will have the flexibility to telecommute* as you take on some tough challenges.Primary Responsibilities:

• Implement and maintain data bases necessary to complete standard quality reports and analysis within agreed upon deadlines surrounding the MLTSS population
• Complete ad hoc reports as requested
• Routinely analyze results of quality reviews to report error trends
• Manage assigned special projects to completion within target date
• Create Quality system tools / databases to capture relevant data
• Use creativity to solve problems
• Strong clinical judgment
• Demonstrate leadership in continuous improvement
• Utilize change management to drive results
• Develop recommendations for quality remediation plans
• Share best practices and support team goals and objectives
• Drive consistency and efficient processes on the team
• Actively participate in quality improvement initiatives / meetings
• Responsible for maintaining and increasing self-proficiency in the use of quality tools and methods and the application of quality science
• Interface with many internal clinical staff and external providers to gather quality concern information for quick turn-a-round state reporting to avoid liquidated damagesYou'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:
  • Bachelors Degree in related field or equivalent experience
  • 2+ years of experience working within a Health Care or Managed Care environment
  • Solid experience in tracking and trending reportable event/critical incident data
  • Solid computer skills including the ability to create and manipulate Excel spreadsheets
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodationPreferred Qualifications:
    • RN, LCSW, LBSW or LMSW within the state of Tennessee
    • Experience in a Managed Long Term Services and Supports (MLTSS)environment
    • Medical record review experience
    • Knowledge of health care products, delivery systems, claims processing and supporting systems
    • Knowledge of quality improvement methods and tools (SPC, Six Sigma)Soft Skills:
      • Excellent interpersonal and communication skills
      • Reporting skills and strong analytical skills
      • Ability to write clearly and help with word processing when necessary
      • Ability to clearly communicate with internal and external audiences
      • Ability to be flexible and work with ambiguity
      • Ability to self-direct work with strong problem-solving skills
      • Ability to multitask and prioritize
      • Ability to work collaboratively
      • Embrace a growth mindset
      • Highly motivatedTo protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.Careers with UnitedHealthcare. -Let's talk about opportunity. Start with a Fortune 5 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)*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.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. - - -

Keywords: UnitedHealth Group, Nashville , Clinical Quality Analyst - LTSS - Telecommute in TN, Healthcare , Brentwood, Tennessee