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 TRICARE Director of Accreditation, RN required - Phoenix, Arizona, United States

   
Job information
Posted by: UnitedHealth Group 
Hiring entity type: Insurance 
Work authorization: Existing work authorization required for United States
Position type: Direct Hire, Full-Time 
Compensation: ******
Benefits: See below
Relocation: Not specified 
Position functions: Health - Physician
Nursing - Clinic RN
Nursing - Management
 
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: 522357 / Latpro-2482811 
Date posted: May-16-2013
State, Zip: Arizona, 85006

Description

United Health Care Military and Veterans is currently seeking a Director of Accreditation for Clinical Quality Management Team.  In this role, you will be directly responsible for the supervision of accreditation coordinators and leading successful accreditation activities. Organizes and leads cross-functional accreditation teams. Conducts accreditation gap analysis and budget and cost benefit analysis as needed. Consults with united Healthcare Military & Veterans (UHCM&V) staff and other key   United Healthcare staff on accreditation standards with heavy focus on NCQA standards. Integrates and incorporates current NCQA standards and methodologies into all work products.  This position contributes to the development of the Annual Clinical Quality Management Plan and Annual Clinical Quality Management Report. Participates on UHCM&V Quality Committees.
 
Key Responsibility Areas:
  • Collaborates and facilitates with other departments to identify, develop, and evaluate projects which improve the delivery of clinical quality health care using NCQA methodology.
  • Liaison for CQM department with other accreditation staff in other businesses.
  • Ensures NCQA accreditation standards are incorporated and maintained in UnitedHealth care Military & Veterans
  • Hires and trains accreditation and compliance staff.
  • Oversee work performed by CQM Compliance analyst.
  • Creates project planning documents, including process flow charts, work plans and Gantt charts using various software programs.
  • Performs research, both primary and secondary, with minimal direction or supervision.
  • Effectively and sensitively communicates with others while modeling effective facilitation and management skills.
  • Maintains confidentiality and non-discoverability of all activities.
  • Performs all other duties as assigned.
  Working Conditions:
  • Favorable working conditions in a climate-controlled office space; works within an office environment or telecommutes; level II IT security clearance. 95% of time spent working at a desk using a computer, on telephone 5%, lifting and filing materials up to 20 lbs.
  • Travel may be 10% of time.




Requirements

  • RN with BSN, BA in business or healthcare administration required. Masters preferred
  • Must have previous experience with National Accreditation Organizations required (5 years)
  • Two years supervisory experience required
  • United States Citizenship
  • Ability to obtain favorable adjudication following submission of Department of Defense form SF86 NAC form SF86.
  • CPHQ preferred
  • TRICARE or other federal government experience preferred. 
Knowledge, Skills and Abilities:
  • Knowledge of the TRICARE Operations Manuals.
  • Knowledge of benchmarking practices and data extraction.
  • Knowledge of TJC/NCQA standards and methodologies.
  • Strong statistical, analytical and problem-solving skills.
  • Strong Microsoft Office Professional skills (Excel, Word, PowerPoint, and other statistical processing tools).
  • 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 facilitate 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, analyze, and synthesize quality data in an appropriate reporting format.
  • Excellent interpersonal, communication, team building and writing skills.
 
As a requirement of UnitedHealth Group’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 “NACâ€).  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.
 
 
Careers at UnitedHealthcare Military & Veterans. When it comes to their health care, the men and women who help keep the peace deserve the greatest peace of mind. That’s why UnitedHealthcare is the organization that’s called on to serve them and their loved ones. We’re all about finding better ways to help improve their lives no matter where life may take them. So our career opportunities take challenge to a higher level. If you have a commitment to quality that mirrors our commitment to the men and women of the armed forces, take time to learn more about the career paths available here. It’s a genuine opportunity to do your life’s best work.
 
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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