Clinical Quality RN - Telecommute - Colorado (16108423)
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)
Doing the right thing is a way of life at Rocky Mountain Health Plans (RMHP). As part of the UnitedHealthcare family of plans, RMHP provides innovative health insurance coverage and personalized attention to individuals of all ages and business of all sizes throughout Western and rural Colorado. RMHP is continually striving to improve the health and wellness of our Members and partners in the state where we live, work, and play - because we’re Colorado, too.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Prefer resident of Colorado
- Utilizes technical and professional experience to implement and monitor performance goals
- Utilizes specialized clinical knowledge of physical and behavioral health care to support quality review activities. Integrates this activity with other initiatives such as HEDIS and other health plan activities and key performance indicators
- Utilize project management skills including planning, development, coordination, monitoring, reporting and evaluations of program/initiatives
- Participates in or coordinates with other department projects as needed
- Travel to job related meetings and activities may be required
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.
- Bachelor’s Degree in Nursing with a current, unrestricted independent licensure as a Registered Nurse or a Master’s Degree in Health Informatics, Healthcare Administration/Management or Quality Management
- 3+ years of clinical experience
- 1+ years of experience with coordinating and monitoring projects and programs
- 1+ years of experience with MS Office, including Word, Excel, and Outlook
- Experience with quality improvement principles to include research and measurement
- Knowledge base of clinical standards of care, preventive health standards, HEDIS, NCQA, governing and regulatory agency requirements
- Ability to evaluate medical records with attention to detail and prepare reports as needed
- Current, unrestricted independent licensure as a Registered Nurse in Colorado
- 1+ years of working in managed care or insurance industry, and working with coordinating and monitoring projects and programs
- Experience with health data analysis and health education
- Demonstrated skills in technical / professional writing and presentations
- Attention to detail
- Solid organizational skills and ability to interact with company staff at all levels
- Colorado state resident
- 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
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
Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)
Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $54,400 to $97,000. The salary range for Connecticut / Nevada residents is $60,000 to $106,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
*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.