UnitedHealth Group Clinical Quality RN - Telecommute in Phoenix, AZ in Phoenix, Arizona

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm)

If you are located in Phoenix, AZ, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Review and audit medical documentation/charts and records

  • Assist with report preparation and records regarding work function activities and projects

  • Coordinate quality management and Special Needs Plans Models of Care (SNP MOC) related programs and activities as required

  • Supports quality improvement programs

  • Participates in and represents the Clinical Quality Team by collaborating with internal business partners focusing on quality improvement

  • Participates in or coordinates with other department projects as needed

Required Qualifications:

  • Clinical RN with current, unrestricted license in state of residence

  • 5+ years of clinical experience

  • 3+ years of clinical quality experience

  • 1+ year working in managed care or in the insurance industry

  • Ability to evaluate medical records with attention to detail to perform quality audits

  • Strong organizational skills, self-motivated and ability to interact with company staff at all levels

  • Experience with Medicare and/or Medicaid

  • Knowledge base of clinical standards of care, preventive health standards, HEDIS, NCQA, governing and regulatory agency requirements

  • Proficiency in software applications that include, but are not limited to, Microsoft Word, Microsoft Excel, Microsoft PowerPoint

Preferred Qualifications:

  • Demonstrated ability to assist with focusing activities toward a strategic direction as well as develop tactical plans, drive performance and achieve targets

  • Ability to do formal presentations in different settings- internal/external auditors, reporting on projects and reports that have been created and analyzed

  • Subject matter expert for CMS Special Needs Plans Models of Care (SNP MOC)

  • Experience with project coordination

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

*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.

Keywords: RN, nurse, quality experience, telecommute, work from home, remote, Phoenix, AZ, Arizona