Director HEDIS Quality Dallas TX (16143694)
Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)
The Director of Quality/HEDIS is responsible for coordinating and implementing quality initiatives designed by enterprise/OHCC to continuously improve all aspects of health care delivery. This includes communication and monitoring of initiatives as well as promoting culture changes that support an environment of quality. This position is also responsible for coordinating and implementing HEDIS, CAHPS and HOS projects and assisting with data analysis and report preparation for Regional Success Collaborative as well as OHCC. The Director works closely and collaboratively with various functional areas of the delivery system and OHCC to achieve the goals and objectives of the QI/HEDIS program.
- Provides leadership and support in establishing and directing the Quality Program consistent with the delivery system/OHCC directives
- Develops and/or maintains policies and procedures that support the corporate initiatives that meet State, Federal legal requirements and standards
- Collaborates with physicians to execute the implementation of the clinical quality data initiatives as defined by enterprise and/or OHCC
- Provides expertise to the training department on HEDIS measures and tools that support collection of and communication about HEDIS to the enterprise
- Works with Enterprise on developing and implementing HEDIS member engagement strategies
- Works with OHCC leadership to provide information or data as requested
- Facilitates, integrates, and/or coordinates the implementation and evaluation of identified quality improvement/HEDIS activities as requested by UHG or related companies
- Promotes understanding, communication and coordination of all quality improvement program components
- Participates in requested evaluations and audits
- Coordinates reporting on quality initiatives to all appropriate committees
- Assists with the development of the QM and UM Work Plan, Evaluation and the monitoring of Work Plan activities as they relate to PI
- Develops operating budget as necessary
- Participates in various teams, committees and meetings at any level required to maintain business necessity
- Maintains QI program documents, reports, and committee minutes and follows all internal privacy and confidentiality policies and procedures
- Maintains current knowledge of regulatory requirements associated with the QI program
- Oversees HEDIS data submission process
- Leads accreditation efforts as defined by enterprise
- Performs all other related 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.
- Bachelor’s degree in Registered Nursing or related field
- 8+ years of experience in quality improvement in a managed care environment and/or large physician practice setting, including three or more years of management experience
- Basic understanding of quality improvement standards such as NCQA, HEDIS, CAHPS, HOS and CMS
- Established and managed an annual budget
- Proficient knowledge of Microsoft Office applications required, including, but not limited to, Word, Excel, Access, and PowerPoint
- 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
- Master's Degree (MBA, MHA, MPH, MN or related field)
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 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 550,000+ 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)
WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.
**PLEASE NOTE** The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time, or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.