UnitedHealthcare ยท 2 months ago
Quality Improvement Program Manager - Remote on Oahu, HI
United States
Full-time
Remote
Mid Level
$71K/yr - $127K/yr
3+ years expUnitedHealthcare is focused on simplifying the health care experience and creating healthier communities. The Quality Improvement Program Manager will coordinate quality improvement and compliance activities, ensuring that organizational and regulatory requirements are met while improving member outcomes and provider performance.
FitnessHealth CareWellness
Responsibilities
Develop and implement data-driven strategies to support quality improvement initiatives
Maintain and enhance reporting systems for HEDIS, Stars, CAHPS, and other regulatory and internal quality metrics
Conduct data analysis to identify trends, gaps, and opportunities for improvement
Support quality improvement projects with data analysis, performance tracking, and outcome measurement
Manages all Quality Committees under the UnitedHealthcare Community Plan Hawaii umbrella to assure that QM Committee activities are fulfilled, on track and recorded
Serves as a liaison with national Quality Committees to communicate back information to the local plan as needed
Support with quality management documents such as the Quality Improvement Program Description, Quality Improvement Work Plan and the Quality Improvement Program Evaluation are completed, presented for approval and submitted timely
Evaluations are written and updated as required to fulfill requirements of UHC national QMP, NCQA and State regulations
Manages existing QMP policy & procedures, writes new QMP policy & procedures and matches policy and procedure to regulatory requirement and accreditation crosswalk, and ongoing regulatory and accreditation readiness
Provide project management oversight for all activities associated with HEDIS, CAHPS, PIPs, and other projects as assigned
Conducts performance improvement projects and complete submission of necessary reports
Participate in quality related audits (i.e. EQRO, HEDIS, etc.) and assures that all QMP requirements under the audit are met
Manages quality related reports as required by State, NCQA, etc
Prepare effectiveness studies on program activities to identify improved outcomes and status of meeting set objectives
Other duties as assigned
Qualification
Required
3+ years of experience in the health care field with a focus on healthcare data analysis and quality improvement
Experience with data visualization platforms (e.g., Tableau, Power BI)
Experience with MS Word, Excel, PowerPoint, Outlook
Solid understanding of HEDIS, Stars, CAHPS and other healthcare quality metrics
Demonstrated excellent communication and project management skills
Ability to travel about 10% of the time on Oahu, HI
Preferred
1+ years of experience with HEDIS, Stars, CAHPS and other healthcare quality metrics
1+ years of experience working in health plan or other setting in quality management
Knowledge of regulatory agencies including NCQA
Benefits
Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution
Company
UnitedHealthcare
UnitedHealthcare helps people live healthier lives by simplifying the health care experience.
10001+ employees
H1B Sponsorship
UnitedHealthcare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (48)
2024 (26)
2023 (45)
2022 (61)
2021 (60)
2020 (68)
Funding
Current Stage
Late StageLeadership Team
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