Join Optum as a Senior Quality Nurse to drive quality improvement initiatives and collaborate with providers to enhance healthcare standards. Your expertise will help achieve high STAR ratings while working in a dynamic environment that supports your professional growth.
Key Responsibilities
Develop business plans to motivate providers to improve STARS measure performance
Provide analytical interpretation and STARS/HEDIS performance summaries to provider groups
Serve as the subject matter expert for all STARS-related activities
Participate and present in business review meetings related to STAR activities
Analyze provider structure and characteristics to improve STARS measure performance
Assist in developing STARS/HEDIS presentation materials for provider performance meetings
Required Qualifications
Registered Nurse within NM and/or a compact state
4+ years of healthcare experience
2+ years of experience in provider-facing interactions
Experience using Microsoft Office applications
Ability to review clinical data and provide recommendations
Valid NM Driver’s license and ability to travel 75% locally
Preferred Qualifications
2+ years of experience in HEDIS/STARS, preferably in a clinical quality consultant role
2+ years of data analysis and/or quality chart review and abstraction
Billing and CPT coding experience
Medicare and/or Managed Care experience
Benefits & Perks
Comprehensive benefits packageIncentive and recognition programsEquity stock purchase401k contribution