Clinical Quality Consultant -Hybrid Orlando Market

Explore opportunities with WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will be part of a team who shares your passion for helping people achieve improved health outcomes. Explore rewarding opportunities for physicians, clinical staff and non-patient-facing roles. Join us and discover the meaning behind Caring. Connecting. Growing together.

The ClinicalQuality Consultant (CQC)will driveconsistency,efficient processesand sharebest practices, in acollaborativeeffortwith the providers, designed tofacilitate a minimum 4 STARperformance.The CQCwill participate in quality improvement initiatives, attend monthly or joint operating committee meetings, developrecommendationsfor qualityremediation plansandcreate toolsand databases tocapturerelevant dataforeachregion. This positionwillworkcollaborativelywitheachregional/market teamand their leadership in a matrixrelationship.

This position is Monday- Friday 8am-5pm, Hybrid in Orlando FL

Primary Responsibilities:

• Develop market business plans to motivate providers toengage in improving Stars measures to be 4 STARS or higher
• Provideanalytical interpretation of StarsandHEDISreporting, includingexecutive summaries to planand provider groups
• Primarygo to personforall STARSrelatedactivitieswithin theirassigned market(s)workingwithin a matrixrelationshipwhich includesQualitycorporate operationsand Regional/Market operations
• Lead orparticipateandpresent inweekly, Monthly,Bi-monthly,Quarterlyand/orAnnual business Review meetingsrelated to STARactivitieswhich summarize provider group performanceand market performanceasrequestedby orrequiredbyQuality or Regional leadership
• Analyzeandevaluate provider group structureandcharacteristics, providergroup/provider office operationsandpersonnel to identify the mosteffectiveapproachesand strategies
• Identifyandassess decision makersand other key providergrouppersonnelwith afocus on identifying barriers toachieving targeted outcomes
• Develop solution-based, userfriendly initiatives to support practice success

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:

• 2+ years of Healthcare/Health Plan experience
• 2+ years of HEDIS experience and/or knowledge
• Experience with data management and/or project management

• Knowledge of managed care requirements related to clinical quality

Preferred Qualifications:

• Significant Clinical and/or Health Education experience

• Experience working with HEDIS software vendors (management, building relationships, issue resolution)
• Experienced in medical record review
• Proficiency with Microsoft Windows Suite (PPT, Excel, Word, Visio)
• Proficiency with Microsoft Office applications, including: Word, Excel and PowerPoint
• Basic statistical knowledge and application of continuous quality improvement concepts, such as Six Sigma, Lean, and/or PDSA
  

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 hourly pay for this role will range from $20.00 to $36.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

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.

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