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Clinical Practice Consultant - Tidewater, VA Markets

  • Job
    Full-time
    Senior Level
  • Consulting
    Healthcare
  • East Hampton
    Remote

AI generated summary

  • You must have a current VA nursing license, 5+ years clinical and 2+ years quality improvement experience, strong communication skills, software proficiency, and ability to travel 75%.
  • You will assist in quality measure support, develop training materials, conduct audits, engage with providers, and enhance operational efficiency to improve member health outcomes.

Requirements

  • Current unrestricted nursing licensure required in Virginia
  • 5+ years clinical experience, or other relevant experience
  • 2+ years of quality improvement experience, or other relevant experience
  • Proficiency in software applications that include, but not limited to, Microsoft Word, Microsoft Excel, Microsoft PowerPoint
  • Proven ability to communicate effectively with broad audience: practice-level executive leadership, physicians, nurses, non-clinical office staff, and across the Health Plan
  • Proven commitment to anticipating, understanding, and meeting the needs of internal and external stakeholders
  • Proven ability to make formal presentations within the context of their role
  • Proven excellent verbal and written communication skills
  • Proven ability to use databases and prepare reports as needed
  • Proven capability of working independently as well as collaboratively within a complex, cross-functional team environment
  • Ability to travel to physician offices up to 75% of the time to cover assigned region

Responsibilities

  • Function as a subject matter expert (SME) for quality measures and preventive health topics for Health Plan staff
  • Support state-specific medical record retrieval as directed by the Quality Leadership
  • Assist in the development of Standard Operating Procedures, Job Aids, and educational materials for internal training as needed
  • Serve as a subject matter expert (SME) for assigned HEDIS/State Measures and preventive health topics
  • Support quality program with tasks including, but not limited to, reviewing medical records and system databases to address open care gaps
  • Participate in, coordinate, and/or represent the Health Plan at community-based events, clinic days, health department meetings, and other outreach events focused on quality improvement, member health education, and disparity programs
  • Seek opportunities to improve operational efficiencies/effectiveness
  • May be required to perform other tasks to support quality and/or the health plan as needed
  • Develop strategic partnerships with network providers to assess quality measure trends and to identify opportunities for improvement
  • Drive measure-specific quality transformation through targeted clinical and coding education and best practices to network providers
  • Coordinate and conduct remote or onsite medical record audits to evaluate coding, billing, clinical documentation practices, and measure compliance in accordance with regulatory requirements
  • Deliver constructive, practical feedback and track the intervention through completion to drive quality improvement
  • Coordinate and lead year-round medical record retrieval, review, and submission for assigned providers
  • Document and refer providers’ non-clinical/service issues to the appropriate internal parties

FAQs

What is the role of a Clinical Practice Consultant at UnitedHealthcare?

The Clinical Practice Consultant is responsible for ongoing clinical management of physician practices, focusing on clinical quality, designing and leading initiatives, supporting continuous quality improvement, and developing partnerships with providers.

What qualifications are required for this position?

A current unrestricted nursing licensure in Virginia, 5+ years of clinical experience, 2+ years of quality improvement experience, and proficiency in software applications like Microsoft Word, Excel, and PowerPoint are required.

Is travel a requirement for this job?

Yes, the position requires travel to physician offices up to 75% of the time within the assigned region.

What kind of experience is preferred for candidates applying to this position?

Preferred qualifications include a Bachelor’s degree in science or equivalent work experience, experience working in Medicaid and/or Medicare, and knowledge of clinical standards of care, HEDIS, and managed care industry regulations.

Will I need to participate in community-based events?

Yes, participation in community-based events, clinic days, health department meetings, and other outreach focused on quality improvement and health education is part of the role.

What kind of skills are necessary for effective communication in this role?

Candidates should have excellent verbal and written communication skills, proven ability to communicate with diverse audiences, and the capability to make formal presentations.

Does UnitedHealthcare provide benefits for employees?

Yes, UnitedHealthcare offers a comprehensive benefits package, including incentive and recognition programs, equity stock purchase, and 401k contribution.

What is the salary range for this position?

The salary range for the Clinical Practice Consultant role is $71,600 to $140,600 annually, based on factors such as local labor markets, education, work experience, and certifications.

What is the application deadline for this position?

The job posting will be available for a minimum of 2 business days or until a sufficient candidate pool has been collected, and it may close earlier due to the volume of applicants.

Is UnitedHealthcare an equal opportunity employer?

Yes, UnitedHealthcare is an Equal Employment Opportunity employer and considers qualified applicants without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status.

Science & Healthcare
Industry
10,001+
Employees

Mission & Purpose

When it comes to your health, everything matters. That’s why UnitedHealthcare is helping people live healthier lives and making the health system work better for everyone. Our health plans are there for you in moments big and small, delivering a simple experience, affordable coverage, and supportive care. Wherever your health takes you, we're there for what matters. At UnitedHealthcare, part of the UnitedHealth Group family of businesses, we are working to create a system that is connected, aligned and more affordable for all involved; one that delivers high quality care, responsive to the needs of each person and the communities in which they live. With connections to more than 1.3 million physicians and care professionals and 6,500 hospitals and care facilities across the globe, we can collaborate in new ways to improve patient care while providing customizable and comprehensive solutions in any marketplace, anywhere.

Culture & Values

  • Integrity

    Honor commitments. Never compromise ethics.

  • Compassion

    Walk in the shoes of the people we serve and those with whom we work.

  • Relationships

    Build trust through collaboration.

  • Innovation

    Invent the future. Learn from the past

  • Performance

    Demonstrate excellence in everything we do.

Benefits

  • United Well-being

    United Well-being supports employees in their journey to better health. Resources include: Exercise and mindfulness apps. Tips and recipes for healthy cooking. Wellness coaching and financial tools. A private employee community group.

  • Health and Insurance

    Our medical plans for employees deliver better value and better outcomes. We offer: Copay plans and HSA-eligible plans. Vision and dental plans. Flexible spending accounts. Life insurance, and more.

  • Savings and Retirement

    In addition to competitive pay, we provide financial benefits to help employees manage their money. Benefits include: 401(k) Savings Plan. Employee Stock Purchase Plan. UnitedHealth Group credit union, and more.

  • Paid Time Off (PTO)

  • Paid Company Holidays

  • Parental Leave

  • Employee Assistance Program