RN Clinical Quality Analyst, Reliant Medical Group
Optum
Application
Details
Posted: 20-Jan-23
Location: Worcester, Massachusetts
Salary: Open
Categories:
General Nursing
Internal Number: 120188989
Opportunities with Reliant Medical Group. When you join Reliant, you’ll be part of a community-based, multi-specialty, physician-led medical group. Everyone works collaboratively on a common purpose: improving the quality, cost and experience of health care. With the resources of a global health organization - Optum - behind us, we’re at the forefront of value-based care. Supported by a patient-centric business model - integrated care teams focus on the best patient care, rather than volume. Here, you’ll contribute to an exceptional patient experience. Discover a place where you can help shape the future of health care and do your life’s best work.(sm)
Position Details: Reliant Medical Group Part of Optum
Location: 100 Front Street, Worcester MA
Department: Risk & Quality Management
Schedule: Full-time, Monday - Friday Salaried
Hybrid environment - must be able to report to the physical office as needed
If you are located in Worcester, MA, you will have the flexibility to work remotely*, as well as work in the office as you take on some tough challenges.
Primary Responsibilities:
Participates in the Peer Review Program by performing quality case reviews submitted by risk management, incident reports, audits, sentinel events, clinician referrals or any complaints related to quality of care
Utilizes critical thinking skills when interpreting and incorporating the organization’s policies and procedures to assess and evaluate case medical records, including chart review, provider feedback, and any previous reviews completed on the case to identify and address potential individual provider or operational process issues which impact the quality of care delivered at Reliant
Utilizes critical thinking skills to determine appropriate patient outcome and care ratings based on review findings and communicate the conclusions to providers
Participates with the development and correction of organizational system issue fixes to ensure compliance with legal and other external regulations/requirements to support the continuous performance improvement of the quality of care and service provided by the organization
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:
Graduate from an accredited school of Nursing and current licensure as a Registered Nurse in Massachusetts
5+ years related experience in a healthcare setting including hospital medical/surgical or ambulatory care
Experience utilizing electronic medical records
Knowledge of various software applications such as Microsoft PowerPoint, Excel, Access, Outlook, etc.
Full COVID-19 vaccination is an essential job function 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 compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
Preferred Qualifications:
Demonstrated experience in database management, statistical analysis, and graphics software
To 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 at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.(sm)
OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare’s support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
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.
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.