Quality Improvement Lead
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
The Quality Improvement Lead will support projects aimed at improving the quality of care and services across specific population streams and highly complex initiatives. This role involves utilizing quality improvement (QI) science methodology, including the development of key project documents, data analysis, and multidisciplinary team coordination. The position will lead and support cross-functional teams to drive quality improvement, ensure program effectiveness, and facilitate continuous improvement efforts within the health plan. This position requires a blend of project management skills, data analysis, and an ability to collaborate across departments and external partners.
You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities :
- Lead individual population streams and / or complex initiatives from inception to completion using QI science methodology (e.g., Project Charters, PDSA cycles, Key Driver Diagrams, GEMBAs, Run Charts)
- Complete data analysis to monitor project progress, determine if SMART aims are achieved, and identify root causes of performance issues
- Recommend appropriate resolutions based on data analysis and stakeholder input to drive continuous improvement
- Define performance and results, and collaborate with management, vendors, and service providers to achieve desired outcomes
- Guide and coordinate multidisciplinary teams with minimal oversight, ensuring the alignment of goals and smooth execution of complex projects
- Coach and mentor colleagues and teams on the application of QI science methodology and tools (e.g., IHI Model, PDSA)
- Are a resource for others, offering feedback and guidance to less experienced team members
- Foster a collaborative environment where innovative ideas and process re-engineering are welcomed to drive improvements
- Utilize data analytics to identify opportunities for improvement at multiple levels, including operational, clinical, and quality dimensions
- Drive the analysis of performance data to provide actionable insights and recommendations for improvement
- Collaborate with multiple functions, including Clinical, Member Experience, Operations, Compliance, Network, Behavioral Services, and Pharmacy, to develop and implement effective quality improvement programs
- Initiate and oversee program improvement projects and activities, ensuring alignment with program goals and compliance requirements
- Manage CAHPS / HOS survey efforts and work on quality website content (if required by contract)
- Manage the HEDIS-related initiatives, ensuring timely submission and addressing any issues related to HEDIS performance
- Represent the health plan at internal clinical and quality meetings, regulatory meetings, and relevant community partner workgroups
- Participate in or coordinate with other department projects as needed to ensure the success of quality improvement initiatives across the organization
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 :
3+ years of relevant work experience in project management, consulting, healthcare, or Quality Improvement (QI)Experience with Healthcare Case Management and / or Quality ImprovementExperience working with and leading cross-functional teams in healthcare or quality improvement initiativesExperience with HEDIS, NCQA, CAHPS and PIPExperience working with Medicare and Medicaid populationsFamiliarity with HEDIS and NCQA standards and practicesIntermediate to advanced proficiency with MS Project, Excel, Visio, PowerPoint, and SharePointAdvanced writing and Excel skillsProven solid problem-solving, analytical, and data interpretation skillsProven excellent time management, organizational, and prioritization skills with the ability to balance multiple priorities effectivelyProven excellent written and verbal communication skillsDemonstrated ability to influence and collaborate with a wide range of internal and external stakeholders / resources to move projects and programs forwardPreferred Qualifications :
Certified Professional in Healthcare Quality (CPHQ), IHI certification, or Lean backgroundProject Management Professional (PMP) certification or similar credentialsSkills & Competencies :
Deep understanding of QI science methodologies and the ability to apply them effectively in healthcare settingsProficiency in data analysis and performance measurement, with an emphasis on actionable insights for quality improvementSolid leadership abilities, including team management, coaching, and mentorshipAbility to work independently, define direction, and navigate ambiguity toward clear, actionable outcomesCreative and open to innovative approaches, willing to re-engineer processes as necessary to achieve goalsExceptional ability to manage complex initiatives with minimal oversightThis role is critical in supporting the organization's continuous improvement efforts, ensuring that quality initiatives are effectively managed and executed to meet the health plan's goals and regulatory standards.
All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline : This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.