Clinical Quality Analyst - LTSS - Telecommute in TN
Company: UnitedHealth Group
Location: Jackson
Posted on: May 12, 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, Jackson , Clinical Quality Analyst - LTSS - Telecommute in TN, Healthcare , Jackson, Tennessee
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