[Hiring] Clinical Practice Consultant @UnitedHealth Group

Role Description

The Clinical Practice Consultant will be responsible for strategically developing clinically oriented provider and community based partnerships in order to increase quality scores based on state specific quality measures. Position responsible for ongoing management of provider practice and community education on quality measures. The Behavioral Health Clinical Practice Consultant will work closely with quality leadership to coordinate an interdisciplinary approach to increase provider performance.

Provider education regarding the quality improvement program involves:

• Analysis and review of quality outcomes at the provider level
• Monitoring, measuring and reporting on key metrics to assist providers in meeting quality standards, state contractual requirements and pay for performance initiatives

The Clinical Practice Consultant will focus on tasks that occur in accordance with State, CMS or other requirements as applicable. Position responsible for direction and guidance on provider-focused, clinical quality improvement and management programs.

The role assists contracted providers with:

• Analyzing member care
• Trending quality compliance at the provider level
• Developing action plans and programs to support provider practices in continuous quality improvement using approved clinical practice guidelines, HEDIS, CMS, NCQA and other tools

Position reports to the BHO Quality Manager and BHO Quality Leadership.

If you are located in Las Vegas, NV area, you will have the flexibility to work remotely* as you take on some tough challenges. This role requires up to 50% local travel to provider offices throughout Clark County.

Qualifications

• Current and unrestricted RN license in the state of Nevada
• 2+ years of clinical experience
• Proficient in Microsoft Word
• Ability to travel locally up to 50% of the time to physician offices (Las Vegas area)
• Driver’s License and access to reliable transportation

Requirements

• Bachelor’s degree (preferred)
• Experience with HEDIS, NCQA, governing and/or regulatory agency requirements (preferred)
• Behavioral health experience (preferred)
• Health care and insurance industry experience, including regulatory and compliance (preferred)
• Proficient in Microsoft Excel and PowerPoint (preferred)
• Ability to communicate verbally and through written communication (preferred)
• Ability to analyze, summarize and present data and reports to committees in both verbal and written formats (preferred)
• Ability to work in a team environment (preferred)

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)

Company Description

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve.

We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are 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 and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.