Sr Clinical Quality Specialist RN Required
UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.
Reporting to the Quality Manager, this position will be responsible for the initial review and any needed investigation of Critical Incidents and Quality of Care concerns for our insured population. These reports can involve care in any setting: hospital, nursing home, physician's office, or at home. This position will initially review the report to see how it is to be classified and what kind of further investigation is needed. The employee will file the report with the necessary State agencies and contact by phone and letter the agencies or individuals for more details regarding the report. Finally, the information will be summarized and brought for review to the CI/QOC committee. Reports of the findings will be compiled for the State on a quarterly basis.
This position will need to train the health services team on Critical Incidents and Quality of Care reporting so that they understand its importance and the correct process. Will be functional expert in CI/QOC concerns.
This job will work closely with the Quality Manager, Health Services Director, and Medical Director in completion of the investigation.
Unrestricted RN license in the State of New Mexico
Able to work independently; creative problem solver.
Excellent verbal and written skill
Able to prioritize multiple tasks
Advanced computer skills - including MS Office knowledge of Word and Excel.
UnitedHealthcare Community State is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at UnitedHealthcare Community State.
We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.
This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.
You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
