There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm) The Quality Improvement Manager is responsible for coordinating and implementing the HEDIS and STAR's data collection and works in collaboration with the Director of Quality to develop strategies for achieving a 5 STAR rating. This role assists with data analysis and report preparation for all required data submissions. The Quality Improvement Manager provides direction and support to the various WellMed markets in the implementation of strategies for closing care gaps. This role provides oversight to quality field teams across multiple markets. This role works closely and collaboratively with various functional areas of the delivery system to achieve the goals and objectives of the Quality Improvement Program. ***Orlando, FL ( can live in Treasure Coast or Jacksonville) - Howell Branch office Will travel between market*** Primary Responsibilities: Provides leadership and support in establishing the Quality Performance Initiatives at the market level Collaborates with physicians to execute the implementation of the clinical quality initiatives as defined by enterprise Provides expertise to the training department on STAR/HEDIS measures and on the tools that support the collection of STAR/HEDIS data Work with IT on the interpretation of technical specifications and impact of HEDIS/STAR Measures to the data collection tools and reports utilized for the support of HEDIS/STAR measures Conduct training on HEDIS/STAR measures, HEDIS/STAR data collection software and data collection strategies Participate in NCQA HEDIS or Health Plan audits Work with external vendors on data transmission issues Analyze data for possible data integrity and data deficits Analyze and trend HEDIS/STAR rates, identify barriers to improvement of rates and creating interpretive exhibits Update QI Project templates and Work plan with assigned responsibilities Attend and participate in all QI meetings Performs all other related duties as assigned The information listed above is not comprehensive of all duties/responsibilities performed. This job description is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice.
Required Qualifications:Unrestricted Nursing License in Florida A minimum of 3-5 years management experience Registered Nurse with Undergraduate degree or equivalent experience Prior HEDIS/STAR experience or participation with regulatory reporting Five or more years of healthcare experience to include experience in a managed care setting Three or more years of experience with data analysis Must have a basic understanding of quality improvement standards such as NCQA, HEDIS, CAHPS, HOS and CMS Proven capability to work with people at all levels in an organization Excellent training and presentation skills with solid communication capabilities and practices, both oral and written Demonstrated effective organizational skills Excellent communication, writing, proofreading and grammar skills Strong attention to detail and accuracy, excellent Evaluative and Analytical skills Strong teamwork, interpersonal, verbal, written, and administrative and customer service skills Advanced Experience using Microsoft office applications, including but not limited to databases, word-processing, spreadsheets, and graphical displays Preferred Qualifications: BSN degree or related field Three or more years of process management experience Healthcare Quality Improvement experience CPHQ Certification CHCQM Certification 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 90,000+ 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: quality improvement, manager, management, Florida, FL, Orlando, Treasure coast, Jacksonville
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.