TRICARE Accreditation Manager - Phoenix, AZ - Phoenix, Arizona - 516848

TRICARE Accreditation Manager - Phoenix, AZ - Phoenix, Arizona, United States

Job information

Posted by:	UnitedHealth Group
Hiring entity type:	Insurance
Work authorization:	May consider sponsorship for work authorization for United States
Position type:	Direct Hire, Full-Time
Compensation:	******
Benefits:	See below
Relocation:	Not specified
Position functions:	Nursing - Case Management Nursing - Clinic RN
Travel:	Unspecified
Accept candidates:	from anywhere

Languages:	English - Fluent
Minimum education:	See below
Minimum years experience:	See below
Resumes accepted in:	English
Cover letter:	No cover letter requested
Job code:	516848 / Latpro-2471281
Date posted:	May-03-2013
State, Zip:	Arizona, 85006

Description

This position works under the direction of the director of accreditation. Primary responsibility is to coordinate and conduct accreditation activities for standards related to UM, DM, and CM. You will assist the director of accreditation with establishing cross-functional accreditation teams. Actively participates in meetings and leads work groups as needed. You will prepare application documents and evidence for accreditation surveys. Responds to questions on the administrative steps associated with accreditation. Performs mock accreditation audits and helps to close identified gaps.

Assist all UMV staff and UnitedHealth Group staff with quality improvement projects using NCQA/URAC standards. Integrates and incorporates current NCQA/URAC standards and methodologies in all work products. During Transition- in Phase the of T3 contract for the West Region, will assist with other start up CQM operations. This position contributes to the development of the Annual Clinical Quality Management Plan and Annual Clinical Quality Management Report.

Primary Responsibilities:

Collaborates and facilitates with other departments to identify, develop, and evaluate projects which improve the delivery of clinical quality health care using NCQA methodology.
Previous managerial or supervisory experience required to manage the performance of Accreditation Coordinators as identified by the Accreditation Director
Ensures NCQA accreditation standards are incorporated and maintained in UMV
Assists with managing multiple Clinical Quality Management projects through use of project management tools and scientific methodologies.
Conducts training with Clinical programs re: NCQA standards
Develops file audit tool and training and completes mock file reviews
Identifies risk opportunities and works with Clinical programs to mitigate risks for accreditation success
Creates project planning documents, including process flow charts, work plans using various software programs.
Performs research, both primary and secondary, under guidance of director of accreditation.
Effectively and sensitively communicates with others while modeling effective facilitation and management skills.
Maintains confidentiality and non-discoverability of all activities.
Assist in revisions of Quality Improvement projects.
Opportunity to participate in obtaining data for clinical quality studies, including obtaining baseline data, benchmarks, interventions, monitoring, re-measurement, and reporting.
Opportunity to assist with UMV Patient Safety quality improvement projects.
Opportunity to provide status of all quality improvement projects at quality committees as needed.
Performs all other duties as assigned.

Knowledge, Skills and Abilities:

Understanding of various quality tools and models.
Excellent written, verbal and presentation skills necessary to effectively convey goals and initiatives to team members and staff.
Ability to manage and prioritize multiple tasks and projects efficiently and effectively.
Ability to effectively communicate during meetings.
Ability to maintain complete and accurate records and information.
Ability to independently problem-solve.
Ability to represent the Clinical Quality Management department in a positive and dynamic manner.
Ability to work in a fast-paced, dynamic environment.
Ability to generate quality data in an appropriate reporting format.

Requirements

High school/GED required
Must be actively and professionally licensed as an RN or LPN in AZ
Demeonstrated ability to lead an Accreditation and Re-Accreditation survey is required
Two + years of managerial or supervisory experience required
Microsoft Excel, Power Point, Word proficiency
United States Citizenship
Ability to obtain favorable adjudication following submission of Department of Defense form SF86 NAC form SF86.

Assets:

Bachelorâ€™s degree is preferred
Data analysis experience is a plus
CPHQ Certification preferred

As a requirement of UnitedHealth Groupâ€™s contract with the Department of Defense, this position requires U.S. citizenship and proof of favorable adjudication following submission of Department of Defense form SF86 http://www.opm.gov/forms/pdf_fill/sf86.pdf, (the National Agency Check or â€œNACâ€). Successful completion of the NAC process is a requirement for continued employment in this role. NAC processing will be initiated by our TRICARE Security Officer post-offer, and can take 3-6 months for a final decision communication from the Department of Defense. Candidates will be allowed to begin employment with UnitedHealth Group in this role based on an interim clearance, and final results will be communicated as they are received. Failure to obtain final NAC approval will result in termination from this role.

UnitedHealthcare Military & Veterans is part of the family of companies that make UnitedHealth Group one of the leaders across the US health care system.

We serve those who serve our nation, providing quality health care services to millions of military beneficiaries across the (list region post award).

Our commitment to helping people live healthier lives, and to continue the honor, satisfaction, and quality of the TRICARE military health benefit program is greater than ever. Our efforts complement the Military Health System to demonstrate the best blend of public and private health care solutions.

It's not just business as usual. It is one of our proudest endeavors.

If you're ready to help make health care work better for those who serve our nation. If you are smart, creative, and committed. If you want to make a difference. Consider being part of the elite team at UnitedHealthcare Military & Veterans.

This is an opportunity to share in something special; a chance for all of us to serve, to excel, and to know that we've made a difference for those families who have made our nation stronger.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

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