Manager, HEDIS Quality Training and Education
Company: UnitedHealth Group
Location: Palm Beach
Posted on: June 22, 2022
Job Description:
Do you have compassion and a passion to help others?
Transforming healthcare and millions of lives as a result starts
with the values you embrace and the passion you bring to achieve
your life's best work.(sm)The Quality Training and Education
Manager is responsible for driving consistency and effective
delivery of training of HEDIS/STAR programs across the
organization. The role keeps abreast of various training delivery
techniques, business processes, products and systems. This role
assists in the designing, managing, implementing and evaluating of
training of Quality programs to prepare high quality and highly
competent staff for meaningful contributions in the workplace. This
position will work with Quality training for new employee
on-boarding, clinical orientation/training related to the Quality
department, HEDIS and audit modules, staff competencies, and any
new training initiatives. This position facilitates training to all
new quality department members. This position also works with a
Quality Leaders to ensure successful execution of training
materials.****Seeking HEDIS/STAR Subject Matter Expert****Primary
Responsibilities:
- Implements staff development and clinical staff competency
programs incorporating appropriate adult learning principles
- Conducts Quality training and education programs for providers,
clinic staff, and administrative departments, as assigned
- Provide training on HEDIS/Star Measures, preventive health
topics,
- Provide training to the clinical team to research and design
educational materials for use in practitioner offices; serves as
liaison with key vendors supporting HEDIS/Star Measures: consults
with vendors to design and implement initiatives to innovate and
then improve HEDIS/Star Measure rates
- Follows plan for professional development and actively seeks
out opportunities toincrease expertise in health care education and
quality training programs
- Work with instructional design staff to ensure all new
initiatives, policies and procedures, guidelines, or other
necessary updates are incorporated into orientation/training
programs
- Identify innovative training strategies for learners, including
distance learners
- Leverages creativity and utilizes a wide variety of methods to
present education and training programs
- Designs practice level quality transformation through targeted
clinical education and approved materials related to HEDIS/State
Specific quality measures for provider and staff education during
field visits
- Educate the staff on proper clinical documentation, coding, and
billing practices,state-mandated quality metrics specifications,
provider profiling and pay for performance
- Evaluate the results of post-program surveys and processes to
obtain participant feedback
- Conduct competency skill evaluations at least yearly to ensure
ongoing monitoring of skills and performance
- Educate the staff on how to investigate gaps in clinical
documentation where system variation has impact on rate
calculation, and how to provide effective feedback to providers and
appropriate departments
- Provides job role training to learners for specific behavior
and skill development utilizing effective feedback and motivational
support techniques
- Collaborate with learner's manager and the instructional design
team to identify and provide training needs for staff
- Provide learner specific feedback and recommendations to
learner's manager
- Follows plan for professional development and actively seeks
out opportunities to increase expertise in nursing education and
adult training programs
- Serves on corporate committees, task forces, and/or work
groups
- Assist corporate and local education team and provides input on
tools used to education quality staff and other local provider
support staff
- Ensures all education objectives are being met, both on a
formal and ad-hoc basis
- Includes up to 50 - 75% local travel
- Performs all other related duties as assignedYou'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:
- Bachelor's degree in Nursing, Ancillary Health Care, Health
Care Administration, Business Administration, Public
Administration, or a related field required -(Associate Degree with
an additional 4 years of comparable work experience beyond the
required years of experience may be substituted in lieu of a
bachelor's degree)
- 5+ years of related experience in Quality/HEDIS/CMS Stars, and
-ICD10/CPT/CPT II coding knowledge, Provider Relations
- 2+ years of supervisory experience
- Solid working knowledge of Medicare quality operations
including HEDIS, Stars, Coding and Medicare Advantage
- Knowledge of state and federal laws relating to Medicare
- Ability and willingness to travel, both locally and
non-locally, as determined by business need
- Demonstrated analytical and data representation expertise
- Advanced Microsoft Office skills - proficient in Excel
- Full COVID-19 vaccination is an essential requirement 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 compliancePreferred Qualifications:
- Master's degree in Healthcare Administration, Business
Administration, or a related field
- Solid knowledge base of clinical standards of care,
preventative health and STAR measures
- Project Management experience
- Solid financial analytical background within Medicare Advantage
plans (Risk Adjustment/STARS Calculation models)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 with WellMed.
Our focus is simple. We're innovators in preventative health care,
striving to change the face of health care for seniors. WellMed is
a network of doctors, specialists and other medical professionals
that specialize in providing care for 550,000+ older adults with
over 16,000 doctors' offices in Texas and Florida through primary
and multi-specialty clinics, and contracted medical management
services. We've joined Optum, part of the UnitedHealth Group family
of companies, and our mission is to help the sick become well and
to help patients understand and control their health in a lifelong
effort at wellness. Our providers and staff are selected for their
dedication and focus on preventative, proactive care. For you, that
means one incredible team and a singular opportunity to do your
life's best work.(sm)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.
Keywords: UnitedHealth Group, Palm Beach , Manager, HEDIS Quality Training and Education, Executive , Palm Beach, Florida
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