Senior Clinical Quality Auditor - Remote
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For you, quality counts. For UnitedHealthcare, part of the UnitedHealth Group family of businesses, delivering quality care starts with processes and documentation... standards that are the best in our industry. As a Senior Clinical Quality Auditor, youll be a force for positive change, guiding the development of comprehensive care plans that will help others live healthier lives. Join us and help guide our efforts to improve the patient experience.
Youll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Complete treatment record review audits and provide feedback results
Implementing audit plan for Behavioral Health Providers at all covered levels of care for treatment of mental health and substance use disorders
Initiate and monitor provider corrective action plans (CAPs) as appropriate to improve performance
Travel to Utah to conduct on site audits on an occasional basis
Develop and present recommendations and alternatives to improve quality and/or outcomes for management and executive review
Participate in developing and implementing effective analysis, research and evaluation of quality management metrics
Collaborate in the design, creation and implementation of quality improvement projects and initiatives
Manage and host audit of the customers to include scheduling, organizing records, completing and submitting reports
In addition to fostering teamwork and collaboration, much of your work will involve data analysis. Solid auditing skills are essential. Youll also need the communication and persuasion skills to deal with clinical and non-clinical audiences.
Youll 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:
Currently licensed as a mental health therapist in the state of residence
3 years of professional mental health experience
Experience auditing behavioral health clinical records
Experience developing and implementing performance improvement projects or using data to develop intervention strategies to improve outcomes
Proficient in Microsoft Word, PowerPoint and Excel
Proven professional writing and verbal communication skills when interacting with customers and behavioral health providers
Proven ability to collect, analyze and present data
Proven ability to travel to Utah locations to conduct on site audits of providers
Designated work space and access to install secure high speed internet via cable/DSL in home '
Preferred Qualifications:
Experience with quality measures such as HEDIS
Experience investigating quality of care concerns and critical incidents
Experience identifying data targets and analyzing results related to quality improvement/performance outcomes
Knowledge of the behavioral health services in Salt Lake and Tooele Counties
Knowledge of Medicaid rules and regulations especially 42CFR
Knowledge of ASAM Dimensions and use for assessment and treatment planning
Proven ability to initiate projects and can work on tasks independently
Proven ability to collaborate as a team player to achieve department goals
Proven ability to design, create and implement quality improvement projects and initiatives
All employees working remotely will be required to adhere to UnitedHealth Groups Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New York, New Jersey, Rhode Island, Washington or Washington, D.C. Residents Only: The salary range for this role is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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, youll find a far-reaching choice of benefits and incentives.
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.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location and incomedeserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission.
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
Apply Now
For you, quality counts. For UnitedHealthcare, part of the UnitedHealth Group family of businesses, delivering quality care starts with processes and documentation... standards that are the best in our industry. As a Senior Clinical Quality Auditor, youll be a force for positive change, guiding the development of comprehensive care plans that will help others live healthier lives. Join us and help guide our efforts to improve the patient experience.
Youll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Complete treatment record review audits and provide feedback results
Implementing audit plan for Behavioral Health Providers at all covered levels of care for treatment of mental health and substance use disorders
Initiate and monitor provider corrective action plans (CAPs) as appropriate to improve performance
Travel to Utah to conduct on site audits on an occasional basis
Develop and present recommendations and alternatives to improve quality and/or outcomes for management and executive review
Participate in developing and implementing effective analysis, research and evaluation of quality management metrics
Collaborate in the design, creation and implementation of quality improvement projects and initiatives
Manage and host audit of the customers to include scheduling, organizing records, completing and submitting reports
In addition to fostering teamwork and collaboration, much of your work will involve data analysis. Solid auditing skills are essential. Youll also need the communication and persuasion skills to deal with clinical and non-clinical audiences.
Youll 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:
Currently licensed as a mental health therapist in the state of residence
3 years of professional mental health experience
Experience auditing behavioral health clinical records
Experience developing and implementing performance improvement projects or using data to develop intervention strategies to improve outcomes
Proficient in Microsoft Word, PowerPoint and Excel
Proven professional writing and verbal communication skills when interacting with customers and behavioral health providers
Proven ability to collect, analyze and present data
Proven ability to travel to Utah locations to conduct on site audits of providers
Designated work space and access to install secure high speed internet via cable/DSL in home '
Preferred Qualifications:
Experience with quality measures such as HEDIS
Experience investigating quality of care concerns and critical incidents
Experience identifying data targets and analyzing results related to quality improvement/performance outcomes
Knowledge of the behavioral health services in Salt Lake and Tooele Counties
Knowledge of Medicaid rules and regulations especially 42CFR
Knowledge of ASAM Dimensions and use for assessment and treatment planning
Proven ability to initiate projects and can work on tasks independently
Proven ability to collaborate as a team player to achieve department goals
Proven ability to design, create and implement quality improvement projects and initiatives
All employees working remotely will be required to adhere to UnitedHealth Groups Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New York, New Jersey, Rhode Island, Washington or Washington, D.C. Residents Only: The salary range for this role is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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, youll find a far-reaching choice of benefits and incentives.
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.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location and incomedeserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission.
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
Apply Now