RN Senior Clinical Quality Consultant Compact Lics Telecommute
6 days ago
At 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 will play a critical role in helping us achieve this mission.
Job SummaryWe are seeking a highly skilled and experienced Senior Clinical Quality Consultant RN to join our team. In this role, you will be responsible for providing clinical expertise and guidance to our healthcare providers, ensuring that they are delivering high-quality care to our patients. You will also be responsible for analyzing data and identifying areas for improvement, developing and implementing quality improvement initiatives, and collaborating with other stakeholders to drive positive change.
Responsibilities- Provide clinical expertise and guidance to healthcare providers to ensure high-quality care delivery
- Analyze data to identify areas for improvement and develop quality improvement initiatives
- Collaborate with other stakeholders to drive positive change and improve patient outcomes
- Develop and implement clinical protocols and guidelines to ensure consistency and quality of care
- Conduct regular audits and reviews to ensure compliance with regulatory requirements and internal policies
- Provide education and training to healthcare providers on clinical best practices and quality improvement initiatives
- Participate in quality improvement projects and initiatives to drive positive change and improve patient outcomes
- 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; the ability to analyze problems, draw relevant conclusions and devise and implement an appropriate plan of action
- Experienced using Microsoft office applications, including databases, word-processing, outlook, and excel spreadsheets
- 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
- Bilingual/Vietnamese
We offer a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution. No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. We are 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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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-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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