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UnitedHealth Group VA CCN Clinical Quality Patient Safety Lead - RN Required - Eden Prairie, MN in Eden Prairie, Minnesota

For you, quality counts. For Optum, 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 Clinical Quality Patient Safety Lead RN, 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.

This position works under the direction of the CQM Manager. The individual in this role will be the team lead for investigating medical and surgical potential quality issues and conducting chart reviews. Participates on quality and team committees. The team lead ensures integration of government/contract requirements and URAC/NCQA standards in all work products.

Key Responsibility Areas:

  • Oversight of patient safety processes related to quality issue activities by Medical-Surgical Specialists

  • Triage quality case assignments to Medical-Surgical Specialists

  • Communicates and coordinates key aspects of quality of care concern processes with CQM staff, internal and external customers

  • Collaborates with and supports patient safety specialists in formulating written communications

  • Works predominately in Microsoft Office products (Word, Excel, Power Point), Visio, and quality databases to track and trend quality issues

  • Compiles trending data and prepares quality reports for presentation at CQM Committees

  • Manages a personal workload of cases

  • Develops and conducts oversight of confidential peer review cases and other quality improvement activities

  • Conducts staff audits, runs reports and completes analysis within agreed upon deadlines

  • Collaborates with Medical Directors on quality issues as needed.

  • Leads and participates in quality improvement teams

  • Utilizes change management to drive results

  • Researches and shares best practices standards with the team

  • Develops creative solutions and drives process improvements ina team environment

  • Maintains confidentiality and non-discoverability of all activities

  • Performs all other duties as assigned

Required Qualifications:

  • RN with current, active license without restriction in required state(s)

  • 3+ years of medical / surgical experience

  • 1+ years of experience with clinical quality management or equivalent

  • Prior medical record chart abstraction and peer review experience required

Preferred Qualifications :

  • BSN Preferred

  • CPHQ Preferred

  • Excellent written and verbal communication skills

  • Ability to investigate, analyze, synthesize, and formulate conclusions for multiple sources of complex data

  • Strong computer skills with emphasis on Microsoft Office software (Windows, Word and Excel) and databases

  • Ability to organize quality data in appropriate reporting formats

  • General knowledge of Medicare, VA, TRICARE, or other government health care program

  • Experience within a managed care organization preferred

Location : Eden Prairie, MN - Telecommuting will be considered*

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.


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