Senior Clinical Quality RN

Optum UT is seeking a Senior Clinical Quality RN to join our team in Salt Lake City, UT. Optum is a clinician-led care organization that is changing the way clinicians work and live.

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

This requisition will be a backfill for the Senior Quality RN in Utah.

This position is focused on driving quality improvement and operational excellence within provider groups, with a strategic emphasis on achieving and maintaining a minimum 4 STAR Quality performance. The role collaborates closely with large or complex provider groups to:

• Drive consistency in clinical quality practices
• Share best practices and implement efficient processes
• Lead quality improvement initiatives and recommend remediation plans
• Support gap closure through education and supplemental documentation

The position is accountable for the network's quality performance, directly impacting 55% of the H4604 contract lives. The current RN staffing ratio is 1:12,600 members and 1:20 provider groups, spanning the Utah and Idaho markets. This ratio is evolving due to ongoing growth, with 13 new provider groups added year-to-date through newly executed contracts.

Primary Responsibilities:

• Engage providers and group leadership to improve STAR ratings to 4 or higher
• Train providers and staff on quality measures and improvement strategies
• Interpret and present STAR and HEDIS data to Provider groups
• Track and trend barriers/challenges that exist at their assigned groups so that better outcomes can be achieved
• Analyze clinical operations to recommend effective quality strategies
• Conduct chart audits to improve the clinical documentation process and provide recommendations for improvement
• Serve as the Quality primary point of contact for their assigned IPA groups
• Serve as the subject matter expert for all STAR-related initiatives
• Lead or participate in recurring business review meetings

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Current and unrestricted RN License
• Driver's License and access to a reliable transportation

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.