U

Clinical Practice Consultant - Remote in Northern Idaho

UnitedHealthcare

Bonners Ferry, ID
17 days ago
$71,600 - $140,600

Job Description

Join UnitedHealthcare as a Clinical Practice Consultant to enhance health care quality through strategic partnerships and education. Impact the lives of millions while working remotely in Idaho, focusing on quality improvement and provider support.

Key Responsibilities

  • Manage provider practice quality measures and community education on quality metrics
  • Develop action plans with provider practices to drive quality improvement
  • Educate providers on clinical documentation, coding, and billing practices
  • Analyze and report on key metrics for quality standards compliance
  • Serve as subject matter expert for Medicaid/Medicare HEDIS/CMS measures
  • Identify patient care opportunities and collaborate with physician practices
  • Perform onsite clinical evaluations through medical record audits
  • Investigate gaps in clinical documentation and provide feedback
  • Document and refer non-clinical issues to appropriate internal parties

Required Qualifications

  • 3+ years of Clinical experience in a physician practice, outpatient facility or a FQHC
  • 2+ years of quality improvement experience
  • 2+ years of Medicare / Medicaid experience
  • Proficiency in Microsoft Word, Excel, PowerPoint
  • Reliable transportation to travel to physician offices locally up to 75% of the time
  • Resident of Idaho

Preferred Qualifications

  • Current, unrestricted RN license in the State of ID
  • 2+ years of HEDIS experience
  • Health insurance industry experience, including regulatory and compliance
  • Knowledge of clinical standards of care and preventive health standards

Benefits & Perks

Comprehensive benefits packageIncentive and recognition programsEquity stock purchase401k contribution