Senior Clinical Quality Analyst – Remote

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.  

The Senior Clinical Quality Analyst supports corporate objectives and ensures quality health care by providing oversight of Behavioral Health quality of care through Quality Assurance education and auditing.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Work collaboratively with the Quality Assurance Team, QA Team Lead, RMHP Medical Directors, external providers and clinicians, and others as necessary to ensure the integrity of quality assurance reviews
• Respect confidentiality and maintain confidence as described in the UHG Employee Handbook and acknowledged through signature by all employees. The ability to maintain confidentiality is a critical and essential component of this position
• Awareness of all State and Federal Rules, as well as contracts and billing manuals, in order to effectively audit clinicians, providers, and facilities
• Support program monitoring and audit activities and performance improvement plans by:
  • Gathering and analyzing data
  • Preparing written audit reports for providers and clinicians
  • Working collaboratively to improve the member and provider experiences
• Participate in designing, creating, and implementing program monitoring and audit projects and initiatives
• Assume responsibility for data integrity among various internal groups and/or between internal and external sources
• Support ongoing monitoring and compliance with Critical Incidents to ensure Quality of Care standards and compliance requirements are met
• Educate clinicians and providers on relevant rules and regulations related to quality improvement
• Interfacing with providers to improve clinical performance
• Complete all duties in accordance with company safety policies and practices
• Other functions may be assigned and management retains the right to add or change the duties at any time

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:

• Active and unrestricted Behavioral Health Clinical License such as LCSW, LPC, LMFT or comparable in state of residence
• 3+ years of experience in a health care setting and/or managed care setting
• Intermediate computer skills (Microsoft Word, Excel, Outlook, and Internet) with the ability to navigate a Windows environment
• Access to high-speed internet services along with space for home office set up

*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.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.