Senior Clinical Quality Auditor - Telecommute

Company: UnitedHealth Group
Location: Draper
Posted on: May 10, 2022

Job Description:

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)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, you'll 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. -You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. -Primary Responsibilities:

• Complete treatment record review audits and provide feedback results
• Responsible for 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. Strong auditing skills are essential. You'll also need the communication and persuasion skills to deal with clinical and non-clinical audiences. -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:
  • Master's Degree in a behavioral health profession or RN with Behavioral Health experience
  • 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 -
  • Ability to collect, analyze and present data
  • Proficient in Microsoft Word, PowerPoint and Excel
  • 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 -
  • Professional writing and verbal communication skills when interacting with customers and behavioral health providers
  • Full COVID-19 vaccination is an essential requirement of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliancePreferred Qualifications:
    • Knowledge of Medicaid rules and regulations especially 42CFR
    • Knowledge of ASAM Dimensions and use for assessment and treatment planning -
    • Experience identifying data targets and analyzing results related to quality improvement/performance outcomes -
    • Experience with quality measures such as HEDIS -
    • Initiates projects and can work on tasks independently
    • Collaborates as a team player to achieve department goals
    • Experience investigating quality of care concerns and critical incidents -
    • Knowledge of the behavioral health services in Salt Lake and Tooele Counties
    • Design, create and implement quality improvement projects and initiativesTo protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.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)Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $66,100 to $118,300. The salary range for Connecticut / Nevada residents is $72,800 to $129,900. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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, you'll find a far-reaching choice of benefits and incentives.*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: UnitedHealth Group, Draper , Senior Clinical Quality Auditor - Telecommute, Accounting, Auditing , Draper, Utah