Clinical Quality Consultant I Hybrid in Orlando
Primary Responsibilities
- Develop market business plans to motivate providers to engage in improving Stars measures to be 4 STARS or higher
- Provide analytical interpretation of Stars and HEDIS reporting, including executive summaries to plan and provider groups
- 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.
- Review provider group structure and characteristics, provider group/provider office operations and personnel to identify the most effective approaches and strategies
- Focus communications and efforts accordingly
- Identify solution-based, user-friendly initiatives to support practice success
Required Qualifications
- 1+ years of experience Healthcare/Health Plan
- 1+ years of HEDIS experience and/or knowledge
- Solid knowledge of managed care requirements related to clinical quality
- Solid knowledge of the Medicare market, products and competitors
- Experience in managed care working with network and provider relations
- Microsoft Office specialist with exceptional attention to detail
Preferred Qualifications
- Clinical and/or Health Education experience
- Knowledge base of clinical standards of care, preventative health, and Star measures
- Demonstrated ability to interact with medical staff, peers, and internal company staff at all levels
- Demonstrated ability to solve process problems crossing multiple functional areas and business units
- Proven solid communication and presentation skills
- Proven solid relationship building skills with clinical and non-clinical personnel
- Proven solid problem-solving skills; the ability to analyze problems, draw relevant conclusions and devise and implement an appropriate plan of action
- Proven good business acumen, especially as it relates to Medicare
Physical & Mental Requirements
- Ability to lift up to 10 pounds
- Ability to sit for extended periods of time
- Ability to stand for extended periods of time
- Ability to use fine motor skills to operate office equipment and/or machinery
- Ability to receive and comprehend instructions verbally and/or in writing
- Ability to use logical reasoning for simple and complex problem solving
Pay and Benefits
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).
The hourly pay for this role will range from $24 - $43 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
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.
Benefits
- Life Resources and support to focus on what matters most to you, in every facet of your life.
- Emotional Education, tools and resources to help you reduce and manage stress, build resilience and more.
- Physical Health plans and other coverage to support wellness for you and your loved ones.
- Financial Benefits for today and to help you plan for the future, including your retirement.
We’re honored to be recognized for our exceptional work culture