1+ months

Clinical Quality Consultant II -Tampa, FL - 910158

Tampa, FL 33602
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  • Job Code
    910158

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your lifes best work.(sm)

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The Clinical Quality Consultant II (CQC) will drive consistency, efficient processes and share best practices, in a collaborative effort with the providers, designed to facilitate a minimum 4 STAR performance. The CQC will participate in quality improvement initiatives, attend monthly or joint operating committee meetings, develop recommendations for quality remediation plans and create tools and databases to capture relevant data for each region. This position will work collaboratively with each regional/market team and their leadership in a matrix relationship.

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This position is Monday- Friday 8am-5pm, based in Tampa, FL. Office is located at 500 N. Westshore Blvd. 75% field based (Currently position is temporarily remote)

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Primary Responsibilities:

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  • Develop market business plans to motivate providers to engage in improving Stars measures to be 4 STARS or higher
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  • Provide analytical interpretation of Stars and HEDIS reporting, including executive summaries to plan and provider groups
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  • Primary go to person for all STARS related activities within their assigned market(s) working within a matrix relationship which includes Quality corporate operations and Regional/Market operations
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  • Lead or participate and present in weekly, Monthly, Bi-monthly, Quarterly and/or Annual business Review meetings related to STAR activities which summarize provider group performance and market performance as requested by or required by Quality or Regional leadership
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  • Analyze and evaluate provider group structure and characteristics, provider group/provider office operations and personnel to identify the most effective approaches and strategies
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  • Identify and assess decision makers and other key provider group personnel with a focus on identifying barriers to achieving targeted outcomes
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  • Develop solution-based, user friendly initiatives to support practice success
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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.

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Required Qualifications:

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  • BS/BA Degree (in lieu of degree, the following may be substituted: 6 years of additional comparable work experience beyond the required years of experience OR An Associate Degree with an additional 4 years of comparable work experience beyond the required years of experience)
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  • 2+ years Healthcare/Health Plan experience
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  • 2+ years HEDIS experience and / or knowledge
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  • Experience with data management and/or project management
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  • Knowledge of managed care requirements related to clinical quality
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  • Proficiency with Microsoft Office applications, including: Word, Excel and PowerPoint
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  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
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Preferred Qualifications:

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  • Significant Clinical and/or Health Education experience
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  • Experience working with HEDIS software vendors (management, building relationships, issue resolution)
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  • Experienced in medical record review
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  • Proficiency with Microsoft Windows Suite (PPT, Excel, Word, Visio)
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  • Basic statistical knowledge and application of continuous quality improvement concepts, such as Six Sigma, Lean, and/or PDSA
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Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 380,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

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Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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

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Job Keywords:Clinical Quality Consultant II, Tampa, FL, Florida

Posted: 2021-01-27 Expires: 2021-03-27

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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Clinical Quality Consultant II -Tampa, FL - 910158

UnitedHealth Group
Tampa, FL 33602

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