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Clinical Quality Analyst - St. Louis, MO

UnitedHealth Group


Location:
St. Louis, MO
Date:
03/28/2017
Job Code:
1727861
Apply on the Company Site
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Job Details


Clinical Quality Analyst - St. Louis, MO(Job Number:705507)
Description

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

       

This position will require travel in assigned territory to conduct provider audits, with possible overnight stays required. The work schedule is Monday-Friday daytime hours with no on call required.    

       

If you're a motivated professional who's searching for a new way to use your mental health expertise, we encourage you to apply for this high - visibility position in our Operations division. As our Clinical Quality Analyst, you will travel across the state of Missouri ensuring the highest quality performance from our dedicated staff. You would also gain exposure throughout our organization, and have a chance to advance into a variety of different areas.       

       

Primary Responsibilities:       

  • Reviewing provider policies, procedures and documentation standards and identify areas of improvement, during initial and re - credentialing audits
  • Meet and work collaboratively with other Clinical Quality Analysts on the Provider Performance team on a regular basis
  • Traveling to conduct on-site provider audits throughout Missouri
  • Responsible for providing feedback and recommendations on how to improve areas of deficiency related to provider deficiencies of policies, procedures, and documentation standards during initial and re - credentialing audits
  • Interviewing and investigating quality of care (QOC) concerns, and gaining an understanding of the underlying issues which may have caused the concern
  • Interpreting the information gathered during a QOC audit to develop reports to requesting committees, with recommendations of corrective action
  • Conduct ongoing audits to fulfill contractual requirements
  • Responsible for developing the interviewing strategy prior to completion of the audit in order to answer the concerns related to the initial complaint
  • Scoring audits and writing audit reports
  • Working to ensure our members receive the best possible treatment from a network of high - quality providers

Job Quality Management
Primary Location US-MO-St. Louis
Other Location US-MO-Maryland Heights
Organization Optum Ops-Behavl & Phys Health
Schedule Full-time
Number of Openings 1
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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