Description

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.

Reporting to the Associate Director Clinical Quality, the Senior Clinical Quality RN for Employer & Individual will be responsible for conducting medical record review to support required HEDIS and quality improvement activities. This person will work with the well trained HEDIS data collection team of nurses to oversee timely and accurate data collection and analysis to identify opportunities for improvement.

If you are located within Las Vegas, NV, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Perform HEDIS medical record review for physician offices throughout the state of Nevada
• Complete inter-rater reliability testing and required computer training successfully in order to complete this data collection
• Conduct additional QI audits through medical record review (i.e. RADV)
• Educates physicians, RNs and other (non) clinical employees on improvements to increase compliance

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:

• Current unrestricted RN license in Nevada
• 5+ years of experience in the clinical setting
• 3+ years of HEDIS data collection and medical record / chart review experience
• Electronic Medical Records (EMR) experience
• Intermediate proficiency with Microsoft Excel
• Proficient with MS Word and PowerPoint
• Willing and able to local travel 25% +/- depending on business need

Preferred Qualifications:

• Active Certified Professional Coding (CPC) Certification
• Experience educating Physicians, RNs or other clinical and/or non-clinical employees
• Proven self-motivated and able to learn new computer software quickly

*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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. 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.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves 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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.