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RN QI Interventionist Developer - Grand Junction, CO

Grand Junction, CO 81501
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There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm)

Doing the right thing is a way of life at Rocky Mountain Health Plans (RMHP). As part of the United Healthcare family of plans, RMHP provides innovative health insurance coverage and personalized attention to individuals of all ages and business of all sizes throughout Western and rural Colorado. RMHP is continually striving to improve the health and wellness of our Members and partners in the state where we live, work, and play - because we're Colorado, too. 


Under the direction of QI Department Management, exercises independent judgment to research, develop, and assure implementation of intervention strategies to improve defined and prioritized QI measures. Engage in best practice research as well as member and provider interaction related to developing and implementing strategies. 



Primary Responsibilities:

  • Use advanced knowledge of disease management and solid judgment to assist the QI Department in the improvement of quality as it relates to selected measures such as HEDIS
  • Work with data analysts and others as needed to research and identify issues and trends for various populations, provide research data to be used in intervention development (i.e. physician performance reports, working gap analysis reports, etc)
  • Strategize with management to develop interventions that would improve outcomes for providers and/or members
  • Assure implementation of approved strategies to improve defined and prioritized measures (i.e. HEDIS)
  • Engage in member and provider interaction related to implementing strategies
  • Develop, implement, and manage continuous monitoring mechanisms for evaluating effectiveness of strategies deployed
  • Identify need for and re-tool strategies as necessary
  • Identify and effectively utilize resources available within and outside the company in order to achieve stated objectives
  • Collaborate effectively at all levels of the department and interdepartmentally
  • Participate in internal and external committees as requested by Management
  • Responsible for developing and sending intervention mailings to populations identified based upon trends
  • Responsible for calls to Members as indicated
  • Responsible for calls and or visits to providers as indicated
  • Perform independent, best-practice research of other health plans intervention programs
  • Make recommendations based on findings to improve desired outcomes
  • Assist in the collection of data for the HEDIS report per NCQA requirements
  • Responsible for preparing and maintaining documentation of processes, progress, and outcomes as necessary for regulatory compliance and NCQA requirements



Jobs Rated Reports for Registered Nurse

Posted: 2020-03-25 Expires: 2020-04-25

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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RN QI Interventionist Developer - Grand Junction, CO

UnitedHealth Group
Grand Junction, CO 81501

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Registered Nurse
118th2018 - Registered Nurse
Overall Rating: 118/220
Median Salary: $70,000

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