Director Of Quality Improvement Healthcare Houston Tx

Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together.

The Director of Quality / HEDIS is responsible for coordinating and implementing quality initiatives designed by enterprise / OHCC to continuously improve all aspects of health care delivery.  This includes communication and monitoring of initiatives as well as promoting culture changes that support an environment of Quality.  This position is also responsible for coordinating and implementing HEDIS, CAHPS and HOS projects and assisting with data analysis and report preparation for Regional Success Collaborative as well as OHCC.  The Director works closely and collaboratively with various functional areas of the delivery system and OHCC to achieve the goals and objectives of the QI/HEDIS program.  

• Provides leadership and support in establishing and directing the Quality Program consistent with the delivery system / OHCC directives
• Develops and / or maintains policies and procedures that support the corporate initiatives that meet State, Federal legal requirements and standards
• Collaborates with physicians to execute the implementation of the clinical quality data initiatives as defined by enterprise and / or OHCC
• Provides expertise to the training department on HEDIS measures and tools that support collection of and communication about HEDIS to the enterprise
• Works with Enterprise on developing and implementing HEDIS member engagement strategies
• Works with OHCC leadership to provide information or data as requested
• Facilitates, integrates, and / or coordinates the implementation and evaluation of identified Quality Improvement / HEDIS activities as requested by UHG or related companies
• Promotes understanding, communication and coordination of all Quality Improvement program components
• Participates in requested evaluations and audits
• Coordinates reporting on quality initiatives to all appropriate committees
• Assists with the development of the QM and UM Work Plan, Evaluation and the monitoring of Work Plan activities as they relate to PI
• Develops operating budget as necessary
• Participates in various teams, committees and meetings at any level required to maintain business necessity
• Maintains QI program documents, reports, and committee minutes and follows all internal privacy and confidentiality policies and procedures
• Maintains current knowledge of regulatory requirements associated with the QI program
• Oversees HEDIS data submission process
• Leads accreditation efforts as defined by enterprise
• Performs all other related duties as assigned

This is a Hybrid position that requires 50% travel within the Houston area.  Mileage reimbursement

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.

• Bachelor's degree in Registered Nursing or related field
• 8  years of experience in Quality Improvement in a managed care environment and / or large physician practice setting, including 3 years of management experience
• Experience with establishing and managing an annual budget
• Basic understanding of Quality Improvement standards such as NCQA, HEDIS, CAHPS, HOS and CMS
• Proficient knowledge of Microsoft Office applications required, including, but not limited to, Word, Excel, Access, and PowerPoint
• This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease

• Master's Degree (MBA, MHA, MPH, MN or related field)
• Proven excellent training and presentation skills with solid communication capabilities and practices, both oral and written
• Proven solid interpersonal, verbal, written, and administrative skills
• Demonstrated effective organizational skills
• Proven excellent communication, writing, proofreading and grammar skills
• Proven solid attention to detail and accuracy, excellent evaluative and analytical skills
• Proven solid teamwork, interpersonal and customer service skills
• Proven capability to work with people at all levels in an organization

• Ability to lift up to 25 pounds
• Ability to push or pull heavy objects using up to 25 pounds of force
• Ability to sit for extended periods of time
• Ability to receive and comprehend instructions verbally and / or in writing
• Ability to use logical reasoning for simple and complex problem solving

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.