Clinical Quality Consultant Optum Nv

***Please note that this role is hybrid with time spent in the field as well as working from home***

***Candidates must be local to the Las Vegas area***

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Clinical 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.

Primary Responsibilities:

• Develop market business plans to motivate providers to engage in improving Stars measuresto 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
• 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
• Analyze and evaluate provider group structure and characteristics, provider group/provider office operations and personnel to identify the most effective approaches and strategies
• Identify and assess decision makers and other key provider group personnel with a focus on identifying barriers to achieving targeted outcomes
• Focus communications and efforts accordingly
• Develop solution-based, user friendly initiatives to support practice success
• Performs all other related duties as assigned

M-F 8-5 field based role out in clinics and in office and work from home-variety

You'll 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.

Required Qualifications:

• BS/BA degree (in lieu of degree, the following may be substituted: 6+ years of additional comparable work experience beyond the required years of experience OR An Associate Degree with an additional 4+ years of comparable work experience beyond the required years of experience)
• 2+ years Healthcare/Health Plan experience
• 1+ years HEDIS experience and/or knowledge
• Solid proficiency with Microsoft Office applications, including: Word, Excel and PowerPoint
• Demonstrated ability to assist with focusing activities toward a strategic direction and achieve targets
• Proven solid data management and/or project management skills
• Proven solid knowledge of managed care requirements related to Clinical Quality
• Proven excellent team development skills
• Proven solid interpersonal skills
• Proven excellent time management and prioritization skills
• Proven excellent written and verbal communications skills
• Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

• Significant clinical and/or health education experience
• Experience working with HEDIS software vendors (management, building relationships, issue resolution etc.)
• Experienced in medical record review
• Basic statistical knowledge and application of continuous quality improvement concepts, such as Six Sigma, Lean, and/or PDSA
• Proficiency with Microsoft Windows Suite (PPT, Excel, Word, Visio)

Physical & Mental Requirement:

• Ability to push or pull heavy objects using up to pounds of force

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

Nevada Residents Only: The salary range for Nevada residents is $56,300 to $110,400. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

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.

Diversity creates a healthier atmosphere: UnitedHealth Group is 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.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.