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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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