RN Senior Clinical Quality Consultant Compact Lics Telecommute
4 weeks ago
We are seeking a highly skilled and experienced Registered Nurse to join our Clinical Quality team as a Senior Clinical Quality Consultant. This is a telecommute opportunity that will allow you to work from the comfort of your own home while making a meaningful impact on the lives of our patients.
Key Responsibilities- Perform telephonic, patient-centered clinical consults focused on Care for Older Adults annual pain and functional assessments.
- Outreach telephonically for Transition of Care following hospital discharge to complete reviews and assist with appointment scheduling.
- Meet or exceed established productivity and quality metrics.
- Work a flexible schedule to support the hours of operation of the business.
- Active, unrestricted Registered Nurse license in the United States.
- 4+ years of RN experience, including experience in a managed care setting.
- 2+ years of experience in HEDIS/Star programs, preferably in a clinical quality consultant role.
- 2+ years of call center experience.
- 2+ years of experience with data analysis and/or quality chart reviews.
- Proven solid knowledge of the Medicare HEDIS/Stars measures.
- Demonstrated ability to interact with medical staff, peers, and internal company staff at all levels.
- Ability to manage multiple complex, concurrent projects.
- Proven excellent written and verbal communication and relationship building skills.
- Demonstrated solid problem-solving skills.
- Undergraduate degree or post graduate degree.
- Billing and CPT coding experience.
- Clinical data abstraction experience.
- Adaptable to change.
- Good business acumen, especially as it relates to Medicare.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. 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.
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San Antonio, Texas, United States UnitedHealth Group Inc Full timeSenior Clinical Quality Consultant RN Compact Lics TelecommuteAt UnitedHealth Group, we're committed to helping people live healthier lives and making the health system work better for everyone. As a Senior Clinical Quality Consultant RN, you'll play a key role in our mission by working with our clinical teams to design, implement, and evaluate quality...
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San Antonio, Texas, United States UnitedHealth Group Inc Full timeSenior Clinical Quality Consultant RN Compact Lics TelecommuteAt UnitedHealth Group, we are committed to helping people live healthier lives and making the health system work better for everyone. We believe that everyone, regardless of their background or circumstances, deserves access to quality healthcare. As a Senior Clinical Quality Consultant RN, you...
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San Antonio, Texas, United States UnitedHealth Group Inc Full timeSenior Clinical Quality Consultant RN Compact Lics TelecommuteAt UnitedHealth Group, we are committed to helping people live healthier lives and making the health system work better for everyone. We believe that everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life.We are seeking a Senior...
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