Vice President, National Clinical Quality Outcomes, UBH (several possible locations)

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.



United Behavioral Health, a UnitedHealth Group company, is a leading provider of emotional wellness services. Currently serving over 22 million Americans, our innovative solutions include behavioral health, employee assistance, work/life and pharmacy management services, as well as a unique disability support program. We offer specialized, confidential support to help our members live and work well, and excellent resources and rewards for your career so you can do the same. A healthy business awaits you at UBH.

 

The VP Quality Improvement and Effectiveness will constantly establish and “push the UBH bar” of clinical standards of excellence (combining external NCQA/URAC and internal standards).  She/he will be responsible for the organization’s overall quality improvement functions, including established standards, protocols, organization structure and ad hoc QI audits.  In this capacity the VP will ensure required quality improvement standards from accreditation agencies are met.  She/he will liaison with UBH Care Advocacy Center leadership and Clinical Operations to ensure quality standards are met across the organization. The VP provides direction and coaching to direct reports and subordinate staff to ensure Care Management Center quality improvement programs are being consistently implemented and administered. The VP will work in liaison with BHS, Clinical Program Design, Clinical Operations, EAP, Product Design and Sales to assure and implement value added effectiveness of clinical pilots, corporate clinical programs and customer specific services. Also works in liaison to assure achieving Performance Guarantees expectations around clinical performance.



1.  Develop and maintain quality standards, protocols and consistent QI policies for UBH Care Management Centers.

2.  Provide effective internal communication to all stakeholders regarding new developments and changes in QI requirements that emanate from  accreditation entities or the marketplace.

3.  Facilitating process to reduce variance and non improvement in Clinical Programs/Services/Accreditation Standards.

4.  Develop and maintain organization structure to support QI functions.

5.  Maintain working relationships with care management center management staff and QI Directors to ensure effective information flow and adherence to current QI standards.

6.  Chair internal critical meetings related to QI such as the Quality Improvement Council.

7.  Direct the preparation and provide oversight of accreditation QI requirements related to Care Management Center delegated or independent NCQA/JCAHO behavioral standards.

8.  Manage, coach and develop direct reports. 

9.  Provide input regarding site QI Director Staff to Care Management Center RVPs on ongoing basis.

10. Participates with sales and account management on QI presentations, as appropriate.

11. Interface with key UHC QI staff as necessary on critical committees or projects

12. Other duties as assigned by the CCO.

13. Co-facilitate completion of NCQA regional mock audits.

14. Provide oversight for externally generated data sets (Ingenix).

15. Consult and provide oversight on key accounts.

16. Provide input and oversight on new business implementations related to QI deliverables.

17. Standardize CQI templates for documentation for clinical programs/services for output to accreditation, sales and customer reporting.

18. Accreditation documentation and consultation to organizations and external customers like health plans.

19. Lead QIA process.

20. Establish Quality metrics across organization.

21. CQI implementation to achieve demonstrated improvement.

22. Direct ad hoc audits as necessary to ensure adherence to established QI standards.























Bachelor’s degree required.  Advanced degree or equivalent desirable. Minimum of 10 years experience in quality oversight or clinical position in Healthcare industry, preferably in managed behavioral healthcare.  Thorough working knowledge of accreditation agencies and their QI requirements, including NCQA/JCAHO.  Demonstrated success in implementing QI standards and practices across multi-site healthcare settings.  Experience in introducing QI requirements to healthcare organizations.  Success in managing staff in multiple locations.  Effective in achieving goals through others, including stakeholders who are not direct reports.

 

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V.  Please apply online at