Clinical Practice Consultant - South Central, VA | , VA

Clinical Practice Consultant At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.The Clinical Practice Consultant is a direct, provider-facing role and is responsible for ongoing clinical management of physician practices in the Health Plan. This position focuses on clinical quality by designing and leading measure-specific initiatives and supporting providers in continuous quality improvement to meet contractual performance requirements. Duties involve developing and managing partnerships with providers, educating providers on quality measures and best practices, analyzing and reporting quality outcomes, medical record review and retrieval, and collaborating with multidisciplinary teams internally and externally to enhance provider performance. This role reports directly to the Associate Director of Clinical Quality within the Health Plan.If you reside within a commutable distance of the South Central VA area, you will have the flexibility to work remotely as you take on some tough challenges. 75% in market same day travel to visit providers.This is a Field Based position with a Home-Based Office.Primary Responsibilities:Operational Team Support Function as a subject matter expert (SME) for quality measures and preventive health topics for Health Plan staffSupport state-specific medical record retrieval as directed by the Quality LeadershipAssist in the development of Standard Operating Procedures, Job Aids, and educational materials for internal training as neededServe as a subject matter expert (SME) for assigned HEDIS/State Measures and preventive health topicsSupport quality program with tasks including, but not limited to, reviewing medical records and system databases to address open care gapsParticipate in, coordinate, and/or represent the Health Plan at community-based events, clinic days, health department meetings, and other outreach events focused on quality improvement, member health education, and disparity programsSeek opportunities to improve operational efficiencies/effectivenessMay be required to perform other tasks to support quality and/or the health plan as neededProvider Management Support Develop strategic partnerships with network providers to assess quality measure trends and to identify opportunities for improvementDrive measure-specific quality transformation through targeted clinical and coding education and best practices to network providersCoordinate and conduct remote or onsite medical record audits to evaluate coding, billing, clinical documentation practices, and measure compliance in accordance with regulatory requirementsDeliver constructive, practical feedback and track the intervention through completion to drive quality improvementCoordinate and lead year-round medical record retrieval, review, and submission for assigned providersDocument and refer providers' non-clinical/service issues to the appropriate internal partiesYou'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:5+ years of clinical experience, or other relevant experience2+ years of quality improvement experience, or other relevant experienceProficiency in software applications that include, but not limited to, Microsoft Word, Microsoft Excel, Microsoft PowerPointProven ability to communicate effectively with broad audience: practice-level executive leadership, physicians, nurses, non-clinical office staff, and across the Health PlanProven commitment to anticipating, understanding, and meeting the needs of internal and external stakeholdersProven ability to make formal presentations within the context of their roleProven excellent verbal and written communication skillsProven ability to use databases and prepare reports as neededProven capability of working independently as well as collaboratively within a complex, cross-functional team environmentUp to 75% travel required to physician offices, including long travel days (greater than six hours) and travel outside the assigned regionDriver's license and access to reliable transportationPreferred Qualifications:Current unrestricted nursing licensure in VirginiaExperience working in an office environment for Primary CareExperience working in Medicaid and/or MedicareHealth care and insurance industry experience, including regulatory and complianceKnowledge of one or more of: clinical standards of care, preventive health standards, HEDIS, NCQA, governing and regulatory agency requirements, and the managed care industry*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter PolicyPay 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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. 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.