Clinical Quality RN - Hybrid in Southfield, MI area only Job at UnitedHealth Group
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If you are located in or near Southfield MI, you will have the flexibility to remotely*, as well as work in the office as you take on some tough challenges.
Primary Responsibilities:
- Administering initiatives and projects to align with our state pay for performance activities and state mandated performance improvement plan
- Coordination of vendor work; oversight of vendor work supporting various projects
- Attendance at state meetings representing the health plan as needed as well as various maternal-health meetings throughout the state (perinatal collaboratives and others)
- Serves as a resource to others
- Able to problem solve and make decisions independently
- Participates in a team environment supporting and respecting all members, encouraging achievement of group goals
- Maternal and infant health subject matter expert
- Meets all health plan contract compliance deliverables (i.e. low birth weight, Pediatric Sickle Cell Improvement project, Performance improvement plan and others as designated)
- Maintains ongoing communication and feedback with customers and/or clients to support needs and resolve problems especially as it relates to the Maternal Infant Health Plans
- Supports all health plan requests in a timely manner
- Work effectively with physicians and ancillary staff, both written and verbally
- Ensures alignment and collaboration with our Healthy First Steps modernization intervention
- Support state clinical priorities and compliance deliverables
- Maternal infant health coordinator/coordination
- Other 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:
- Current and unrestricted RN licensure in Michigan
- 1+ years of health plan experience in a managed care organization
- 1+ years of Performance improvement experience
- 1+ years of presentation experience to large and small groups
- Experience with project management
- Experience with working in a highly matrixed organization
- Provider group experience
- Disease management and population health experience
- Computer literate in Microsoft Word, Power Point, Excel and Visio
- Maintain timeliness for deliverables and regulator requests
- Ability to synthesize information especially from meetings and provide that information to internal teams
- Ability to perform complex problem solving related to health care quality and maternal infant health
- Travel as needed for meetings and provider visits
- 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 accommodation
Preferred Qualifications:
- Data analytics experience
- Good organizational and communication skills
- Self-motivated with solid quantitative and organizational skill
- Excellent interpersonal and networking skills
- Ability to manage multiple tasks and projects and changing priorities; prioritize work products effectively
- Ability to work independently, good critical thinking skills, excellent verbal and written communication skills
- Solid ability to work effectively with physicians and ancillary staff, both written and verbally
- Ability to perform complex problem solving related to health care quality
- Ability to look at challenges as opportunities
- Ability to work autonomously
- Ability to look at challenges as opportunities
To 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
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*All employees working remotely 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.
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