1+ months

Senior Clinical Quality Consultant WellMed Orlando - 926019

Orlando, FL 32801
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  • Job Code
    926019

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 achieveyour lifes best work.(sm)

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$500 Sign-On Offered to External Applicants!

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TheClinical 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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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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  • Be the 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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  • Focus communications and efforts accordingly
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  • Develop solution-based, user friendly initiatives to support practice success
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  • Performs all other related duties as assigned
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**PLEASE NOTE**The Sign On Bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time, or per diem basis (Internal Candidates) are not eligible to receive a Sign On Bonus.

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Youll 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, an Associates Degree with 4 additional years of work experience, or 6 additional years of work experience beyond the required years listed
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  • 2+ years of Healthcare/Health Plan experience
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  • 2+ years of HEDIS experience and/or knowledge
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  • Sounddata management and/or project management skills
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  • Solid knowledge of managed care requirements related to clinical quality
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  • Experienceassisting with focusing activities toward a strategic direction and achieve targets
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  • Proficiency with Microsoft Office applications, including: Word, Excel and PowerPoint
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  • You will be asked to perform this role in an office setting or other company location
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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 etc.)
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  • Experienced in medical record review
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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 550,000+ 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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OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCares support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

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Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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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OptumCare 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, Consultant, Port Saint Lucie, Pt St Lucie, Fort Pierce, Ft Pierce, Sebastian, Vero Beach, Stuart, Florida, FL

Posted: 2021-05-13 Expires: 2021-07-04

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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Senior Clinical Quality Consultant WellMed Orlando - 926019

UnitedHealth Group
Orlando, FL 32801

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