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HEDIS Quality Improvement Manager - Orlando, FL (State Travel & RN Required)

UnitedHealth Group

Winter Park, FL
Job Code:
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Job Details

HEDIS Quality Improvement Manager - Orlando, FL (State Travel & RN Required)(Job Number:718144)

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm)


The Quality Improvement Manager is responsible for coordinating and implementing the HEDIS and STAR’s data collection and works in collaboration with the Director of Quality to develop strategies for achieving a 5 STAR rating. This role assists with data analysis and report preparation for all required data submissions. The Quality Improvement Manager provides direction and support to the various WellMed markets in the implementation of strategies for closing care gaps. This role provides oversight to quality field teams across multiple markets. This role works closely and collaboratively with various functional areas of the delivery system to achieve the goals and objectives of the Quality Improvement Program.


Primary Responsibilities:  

  • Provides leadership and support in establishing the Quality Performance Initiatives at the market level
  • Collaborates with physicians to execute the implementation of the clinical quality initiatives as defined by enterprise
  • Provides expertise to the training department on STAR/HEDIS measures and on the tools that support the collection of STAR/HEDIS data
  • Work with IT on the interpretation of technical specifications and impact of HEDIS/STAR Measures to the data collection tools and reports utilized for the support of HEDIS/STAR measures
  • Conduct training on HEDIS/STAR measures, HEDIS/STAR data collection software and data collection strategies
  • Participate in NCQA HEDIS or Health Plan audits
  • Work with external vendors on data transmission issues
  • Analyze data for possible data integrity and data deficits
  • Analyze and trend HEDIS/STAR rates, identify barriers to improvement of rates and creating interpretive exhibits
  • Update QI Project templates and Work plan with assigned responsibilities
  • Attend and participate in all QI meetings
  • Performs all other related duties as assigned

The information listed above is not comprehensive of all duties/responsibilities performed. This job description is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice.

Job Clinical Quality Management
Primary Location US-FL-Winter Park
Other Location 
Organization WellMed Medical Mgmt, Inc
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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