Clinical Quality RN - Remote MST

May 26, 2026

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At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Clinical Quality RN will be responsible for conducting quality of care (QOC) investigation, review and management of the regulatory Incident/Accident/Death (IAD) portal, documenting and communicating findings from these reviews, and preparing reports or summaries for internal and external customers. This position collaborates with the Chief Medical Officer or other Medical Directors to review QOC and other investigations and ensures that QOC investigations comply with all applicable State, Federal, and regulatory requirements. These activities are used to ensure care and services provided to our members are timely, adequate, and compliant with regulatory and professional standards and guidelines. If you are willing to work 8:00am - 5:00pm Mountain Standard Time zone, you will have the flexibility to work remotely* as you take on some tough challenges.Primary Responsibilities: <ul><li>Perform clinical documentation review of inpatient and outpatient care delivered to adults and children with Medicaid, Medicare health care benefits through Arizona United Health Care Community Plans for peer review and internal investigations of Quality of Care concerns</li><li>Create professionally written case investigation summaries for Peer Review, present case summaries at the Provider Advisory Committee as applicable</li><li>Review plans of correction from providers in response to a substantiated QOC occurrence</li><li>Effectively interface with external customers, facilities, members and providers to resolve quality of care concerns, obtain medical records and other information </li><li>Conduct delegated oversight reviews of contractors that perform work on behalf of UnitedHealthcare. This includes reviewing samples of contractor work against an audit tool or information found in medical charts</li><li>Collaborate internally with Medical Directors and staff in other UHCCP departments</li><li>Manage multiple tasks and projects and changing priorities; prioritize work products effectively</li><li>Maintain timeliness for deliverables and regulator requests</li><li>Be able to work independently, good critical thinking skills, excellent verbal and written communication skills</li></ul>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: <ul><li>Active, unrestricted RN license in the state of Arizona or compact license</li><li>5+ years of experience working as a Registered Nurse</li><li>2+ years of hospital experience as a Registered Nurse</li><li>Experience evaluating and auditing medical records</li><li>Demonstrated intermediate skills in Microsoft Office, Word, and Excel ability to work with multiple databases to retrieve and enter information</li><li>Demonstrated excellent writing skills - ability to analyze information and prepare written summaries</li><li>Willingness to work a shift of 8am – 5pm Mountain Standard Time</li></ul>Preferred Qualifications: <ul><li>1+ years of experience in quality management and clinical quality investigations, or equivalent experience</li><li>Proven knowledge of Medicare/Medicaid regulations</li><li>Demonstrated solid understanding of quality improvement principles and practices</li><li>Experience working in a deadline driven environment prioritizing responsibilities</li><li>Experience in Behavioral Health Services</li></ul><span class="TextRun SCXO45900659 BCX8 NormalTextRun" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;font-style:normal;font-variant-caps:normal;font-variant-ligatures:none !important;font-weight:400;letter-spacing:normal;line-height:18.4px;margin:0px;orphans:2;padding:0px;text-align:left;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;" data-contrast="auto" xml:lang="EN-US" lang="EN-US">*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.<span class="EOP SCXO45900659 BCX8" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;line-height:18.4px;margin:0px;orphans:2;padding:0px;text-align:left;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;"> <span class="TextRun SCXO15527285 BCX8 NormalTextRun" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;font-style:normal;font-variant-caps:normal;font-variant-ligatures:none !important;font-weight:400;letter-spacing:normal;line-height:20.7px;margin:0px;orphans:2;padding:0px;text-align:left;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;" data-contrast="auto" xml:lang="EN-US" lang="EN-US">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 <span class="TextRun SCXO15527285 BCX8 NormalTextRun" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;font-style:normal;font-variant-caps:normal;font-variant-ligatures:none !important;font-weight:normal;letter-spacing:normal;line-height:20.7px;margin:0px;orphans:2;padding:0px;text-align:left;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;" data-contrast="auto" xml:lang="EN-US" lang="EN-US">range<span class="TextRun SCXO15527285 BCX8 NormalTextRun" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;font-style:normal;font-variant-caps:normal;font-variant-ligatures:none !important;letter-spacing:normal;line-height:20.7px;margin:0px;orphans:2;padding:0px;text-align:left;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;" data-contrast="auto" xml:lang="EN-US" lang="EN-US"> <span class="TextRun SCXO15527285 BCX8 NormalTextRun" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;font-style:normal;font-variant-caps:normal;font-variant-ligatures:none !important;font-weight:400;letter-spacing:normal;line-height:20.7px;margin:0px;orphans:2;padding:0px;text-align:left;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;" data-contrast="auto" xml:lang="EN-US" lang="EN-US">from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.<span class="EOP SCXO15527285 BCX8" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;line-height:20.7px;margin:0px;orphans:2;padding:0px;text-align:left;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;"> <div class="OutlineElement Ltr SCXO225183688 BCX8" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;background-color:rgb(255, 255, 255);clear:both;color:rgb(0, 0, 0);cursor:text;direction:ltr;font-family:" segoe="" ui",="" "segoe="" ui="" web",="" arial,="" verdana,="" sans-serif;font-size:12px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px;orphans:2;overflow:visible;padding:0px;position:relative;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;"=""><p class="Paragraph SCXO225183688 BCX8" style="-webkit-tap-highlight-color:transparent;-webkit-user-drag:none;background-color:transparent;color:windowtext;font-kerning:none;font-style:normal;font-weight:normal;margin:0px;overflow-wrap:break-word;padding:0px;text-align:left;user-select:text;vertical-align:baseline;" xml:lang="EN-US" lang="EN-US"> </div><div class="OutlineElement Ltr BCX8 SCXO225183688" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;background-color:rgb(255, 255, 255);clear:both;color:rgb(0, 0, 0);cursor:text;direction:ltr;font-family:" segoe="" ui",="" "segoe="" ui="" web",="" arial,="" verdana,="" sans-serif;font-size:12px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px;orphans:2;overflow:visible;padding:0px;position:relative;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;"=""><p class="Paragraph SCXO225183688 BCX8" style="-webkit-tap-highlight-color:transparent;-webkit-user-drag:none;background-color:transparent;color:windowtext;font-kerning:none;font-style:normal;font-weight:normal;margin:0px;overflow-wrap:break-word;padding:0px;text-align:center;user-select:text;vertical-align:baseline;" xml:lang="EN-US" lang="EN-US"><span class="TextRun SCXO225183688 BCX8 NormalTextRun" style="-webkit-tap-highlight-color:transparent;-webkit-user-drag:none;font-variant-ligatures:none !important;line-height:18.4px;margin:0px;padding:0px;user-select:text;" data-contrast="auto" xml:lang="EN-US" lang="EN-US">At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. </div><div class="OutlineElement Ltr BCX8 SCXO225183688" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;background-color:rgb(255, 255, 255);clear:both;color:rgb(0, 0, 0);cursor:text;direction:ltr;font-family:" segoe="" ui",="" "segoe="" ui="" web",="" arial,="" verdana,="" sans-serif;font-size:12px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px;orphans:2;overflow:visible;padding:0px;position:relative;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;"=""><p class="Paragraph SCXO225183688 BCX8" style="-webkit-tap-highlight-color:transparent;-webkit-user-drag:none;background-color:transparent;color:windowtext;font-kerning:none;font-style:normal;font-weight:normal;margin:0px;overflow-wrap:break-word;padding:0px;text-align:left;user-select:text;vertical-align:baseline;" xml:lang="EN-US" lang="EN-US"> </div><div class="OutlineElement Ltr BCX8 SCXO225183688" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;background-color:rgb(255, 255, 255);clear:both;color:rgb(0, 0, 0);cursor:text;direction:ltr;font-family:" segoe="" ui",="" "segoe="" ui="" web",="" arial,="" verdana,="" sans-serif;font-size:12px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px;orphans:2;overflow:visible;padding:0px;position:relative;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;"=""><p class="Paragraph SCXO225183688 BCX8" style="-webkit-tap-highlight-color:transparent;-webkit-user-drag:none;background-color:transparent;color:windowtext;font-kerning:none;font-style:normal;font-weight:normal;margin:0px;overflow-wrap:break-word;padding:0px;text-align:left;user-select:text;vertical-align:baseline;" xml:lang="EN-US" lang="EN-US"> </div><div class="OutlineElement Ltr BCX8 SCXO225183688" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;background-color:rgb(255, 255, 255);clear:both;color:rgb(0, 0, 0);cursor:text;direction:ltr;font-family:" segoe="" ui",="" "segoe="" ui="" web",="" arial,="" verdana,="" sans-serif;font-size:12px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px;orphans:2;overflow:visible;padding:0px;position:relative;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;"=""><p class="Paragraph SCXO225183688 BCX8" style="-webkit-tap-highlight-color:transparent;-webkit-user-drag:none;background-color:transparent;color:windowtext;font-kerning:none;font-style:normal;font-weight:normal;margin:0px;overflow-wrap:break-word;padding:0px;text-align:center;user-select:text;vertical-align:baseline;" xml:lang="EN-US" lang="EN-US"><span class="TextRun SCXO225183688 BCX8 NormalTextRun" style="-webkit-tap-highlight-color:transparent;-webkit-user-drag:none;font-variant-ligatures:none !important;line-height:19.55px;margin:0px;padding:0px;user-select:text;" data-contrast="auto" xml:lang="EN-US" lang="EN-US">UnitedHealth Group 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. </div><div class="OutlineElement Ltr BCX8 SCXO225183688" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;background-color:rgb(255, 255, 255);clear:both;color:rgb(0, 0, 0);cursor:text;direction:ltr;font-family:" segoe="" ui",="" "segoe="" ui="" web",="" arial,="" verdana,="" sans-serif;font-size:12px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px;orphans:2;overflow:visible;padding:0px;position:relative;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;"=""><p class="Paragraph SCXO225183688 BCX8" style="-webkit-tap-highlight-color:transparent;-webkit-user-drag:none;background-color:transparent;color:windowtext;font-kerning:none;font-style:normal;font-weight:normal;margin:0px;overflow-wrap:break-word;padding:0px;text-align:left;user-select:text;vertical-align:baseline;" xml:lang="EN-US" lang="EN-US"> </div><div class="OutlineElement Ltr BCX8 SCXO225183688" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;background-color:rgb(255, 255, 255);clear:both;color:rgb(0, 0, 0);cursor:text;direction:ltr;font-family:" segoe="" ui",="" "segoe="" ui="" web",="" arial,="" verdana,="" sans-serif;font-size:12px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px;orphans:2;overflow:visible;padding:0px;position:relative;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;"=""><p class="Paragraph SCXO225183688 BCX8" style="-webkit-tap-highlight-color:transparent;-webkit-user-drag:none;background-color:transparent;color:windowtext;font-kerning:none;font-style:normal;font-weight:normal;margin:0px;overflow-wrap:break-word;padding:0px;text-align:left;user-select:text;vertical-align:baseline;" xml:lang="EN-US" lang="EN-US"> </div><div class="OutlineElement Ltr BCX8 SCXO225183688" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;background-color:rgb(255, 255, 255);clear:both;color:rgb(0, 0, 0);cursor:text;direction:ltr;font-family:" segoe="" ui",="" "segoe="" ui="" web",="" arial,="" verdana,="" sans-serif;font-size:12px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px;orphans:2;overflow:visible;padding:0px;position:relative;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;"=""><p class="Paragraph SCXO225183688 BCX8" style="-webkit-tap-highlight-color:transparent;-webkit-user-drag:none;background-color:transparent;color:windowtext;font-kerning:none;font-style:normal;font-weight:normal;margin:0px;overflow-wrap:break-word;padding:0px;text-align:center;user-select:text;vertical-align:baseline;" xml:lang="EN-US" lang="EN-US"><span class="TextRun SCXO225183688 BCX8 NormalTextRun" style="-webkit-tap-highlight-color:transparent;-webkit-user-drag:none;font-variant-ligatures:none !important;line-height:18.4px;margin:0px;padding:0px;user-select:text;" data-contrast="auto" xml:lang="EN-US" lang="EN-US">UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. </div>#RPO #GREEN

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

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