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 Member Engagement Project Coordinator - Telecommute in Milwaukee, WI - MILWAUKEE, Wisconsin, United States

Job information
Posted by: UnitedHealth Group 
Hiring entity type: Insurance 
Work authorization: Not Specified for United States
Position type: Direct Hire, Full-Time 
Compensation: ******
Benefits: See below
Relocation: Not specified 
Position functions: Management - General
Nursing - Clinic RN
Nursing - Education/Training
Project Manager
Travel: Unspecified 
Accept candidates: from anywhere 
Languages: English - Fluent
Spanish - Fluent
Minimum education: See below 
Minimum years experience: See below 
Resumes accepted in: English
Cover letter: No cover letter requested
Job code: 820797 / Latpro-3682316 
Date posted: May-15-2019
State, Zip: Wisconsin, 53201


For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

This position is responsible for managing and tracking all member focused engagement activities to meet quality and performance measure goals. Responsible for the reporting and analysis of member care quality and for the development of plans and programs to support continuous quality improvement using HEDIS and other tools. Responsible for the development and implementation of data collection methodology to meet or exceed minimum performance standards established by the regulator, reporting and analysis of clinical performance measures and performance improvement projects in relation to member facing intervention. This position serves as health plan resource for all member engagement and project reporting.

If you are located in Milwaukee or surrounding areas, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Plan, organize and coordinate all aspects of the member engagement programs
  • Facilitate outreach to encourage members to access preventive care, assist with making appointments/arrangements, as necessary, and identify member barriers to care
  • Partner with local providers to facilitate gap closure events
  • Evaluate and identify potential gap closure activities to improve member engagement
  • Develop member materials in collaboration with marketing team
  • Monitor all aspects of annual provider audit inclusive of collaborating with vendor and national regulatory team, provide education and follow up with providers according to UHC policy and state contract
  • Collection of medical records to support custom measure requirements
  • Manage and track submission of non-claim encounters for state custom measures
  • Develop and/or assist with corrective action plans based on audit findings and customer feedback
  • Develop quarterly reports for quality program tracking and performance
  • Collaborate with the Quality Director, CMO, and others to effectively manage national programs
  • Coordinate with other health plan departments and strategize improvement plan interventions and appropriate outreach activities
  • Participate in the implementation of any required newly developed health initiatives
  • Other projects and/or outreach as assigned

Required Qualifications:

  • Associates Degree or equivalent experience
  • 2+ years healthcare experience or other relevant experience
  • Strong understanding of databases and various computer programs inclusive of excel, word, PowerPoint
  • Understanding of NCQA/HEDIS/CAHPS/member satisfaction
  • Project and/or program oversight experience
  • Experience with data analysis and reporting

Preferred Qualifications:

  • RN licensure or Health Education background
  • Experience working for a Medicaid and/or Medicare health care regulator or insurance organization
  • Experience working with quality improvement activities
  • Bilingual (English and Spanish)
  • Good communication skills
  • Highly organized and detail oriented

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.SM

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy

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.

Job keywords: RN, quality improvement, quality performance, member outreach, clinical quality improvement, clinical quality analyst, clinical analyst, data analyst, Healthcare, healthcare education, healthcare jobs, public health, NCQA standards, Well Child Program, Medicaid, Medicare, managed care, insurance company, member engagement, STARS, quality measures, bilingual, Milwaukee, WI, Wisconsin


Please see job description.


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