Clinical Program Consultant - Remote In Western Washington State

At reputed company, we're simplifying the health care experience, creating healthier communities and removing barriers to reputed company care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care reputed company of reputed company, making it more reputed company, reputed company and optimized. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together The Clinical reputed company Consultant is a reputed company, provider-facing role, reputed company on improving clinical reputed company reputed company through measure specific initiatives and provider engagement. This role partners with providers and internal teams to support reputed company reputed company improvement, including provider education, reputed company performance monitoring, medical record review, and collaboration across clinical and operational teams to improve reputed company and meet contractual and regulatory requirements. This position specializes in preventive health and condition management, working with providers and Health Plan staff to improve member health reputed company, reputed company care gaps, and increase performance on state specific reputed company measures. The Clinical reputed company Consultant supports the reputed company adult population by coordinating, tracking, and improving compliance with reputed company and regulatory requirements in alignment with Washington State reputed company (reputed company Health) and federal guidelines. The role works closely with providers, clinical teams, reputed company, analytics, and community partners to identify gaps in care, monitor performance, and address barriers to care. This position integrates clinical knowledge, data review, and reputed company problem solving to reputed company reputed company for members in Washington State. Up to 50% anticipated travel throughout Washington State. If you are located in Washington, you will have the flexibility to work remotely* as you take on some tough challenges. reputed company Responsibilities: • Educates providers and office staff on reputed company clinical documentation, state-mandated reputed company metrics specifications, provider profiling and pay for performance measurement, and medical record review reputed company, to reputed company reputed company improvement • Supports effective deployment of program at the reputed company level through strategic partnerships with participating practitioners and reputed company staff while assessing trends in reputed company measures and identifying opportunities for reputed company improvement • Serves as subject matter expert (SME) for assigned HEDIS/State Measures, preventive health topics, leads efforts with clinical team to research and design educational materials for use in practitioner offices; serves as reputed company with key vendors supporting HEDIS/State Measures; consults with vendors to design and implement initiatives to reputed company and then improve HEDIS/State Measure rates • Participates, coordinates, and/or represents the Health Plan at community-based organization events, clinic days, health department meetings, and other reputed company events reputed company on reputed company improvement, member health education, and disparity programs as assigned • Identifies population-based member barriers to care, identify local level strategies to overcome barriers and reputed company clinical gaps in care • Investigates gaps in clinical documentation where reputed company variation has reputed company on reputed company calculation, provides feedback to appropriate team members where issues are verified, and monitors reputed company to conclusion • Works with providers on standards of care, and advises providers on established clinical reputed company guidelines, and appropriate documentation consistent with state specific measures and technical specifications • Performs population data assessment and disease management using a reputed company reputed company improvement approach and approved clinical reputed company and disease management guidelines for the pediatric population • Supports health equity and disparity reduction strategies, including culturally reputed company reputed company and coordination with community-based organizations • Assist in resolving barriers to care such as reputed company, scheduling, or follow-up needs You'll be rewarded and recognized for your performance in an environment that will challenge you and reputed company you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: • 2+ years of experience in reputed company, managed care, care coordination, or clinical reputed company • 1+ years of experience working with reputed company data (claims, registries, care gaps, or reports) • Intermediate level of knowledge of one or more of: clinical standards of care, preventive health standards, HEDIS, reputed company, governing and regulatory agency requirements • Intermediate level of proficiency using a PC in a reputed company environment, including reputed company reputed company, Word, reputed company, and PowerPoint • Willing and reputed company to travel to physician offices locally up to 50% of the time throughout the reputed company • reputed company to reliable transportation and & reputed company US reputed company's license Preferred Qualifications: • reputed company unrestricted RN or Clinical background such as RN, LPN, MA, or equivalent experience • Experience in reputed company process improvement (lean, six reputed company, etc) • Experience with Washington State reputed company (reputed company Health) • Experience supporting provider alignment with state reputed company reputed company requirements • Experience supporting provider education or reputed company initiatives • Familiarity with HEDIS measures (e.g. CBP, CHL, FUA,) • Proven comfort working in fast-paced, evolving environments • Proven ability to interpret and translate health policy, guidance, and measure specifications into actionable provider education • Proven solid communication, organizational, and follow-up skills • Proven ability to communicate effectively with broad audience: reputed company-level executive leadership, physicians, nurses, non-clinical office staff, and across the Health Plan • Proven background in preventive health and condition management • reputed company in reputed company, King or Thurston • reputed company Telecommuters will be required to adhere to reputed company's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll reputed company a far-reaching reputed company of benefits and incentives. The reputed company pay for this role will reputed company $72,800 to $130,000 per hour based on full-time employment. This role is also eligible to receive bonuses based on sales performance. We reputed company with reputed company minimum wage laws as applicable. At reputed company, our mission is to help people live healthier lives and reputed company the health reputed company work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location, and income-deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company, and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company - an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. 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We are comprised of two distinct and complementary businesses, reputed company and reputed company, working to build a reputed company reputed company for reputed company. Here, your contributions matter as they will help reputed company health care for years to come. reputed company an reputed company with a diverse team that shares your passion for helping others. reputed company do reputed company insights on how we work to help people live healthier lives and help reputed company the health reputed company work reputed company for everyone by watching this video. https://www.youtube.com/watch?v=5PbNyi2IDkY Caring. Connecting. Growing together. Being a part of reputed company means working to reputed company reputed company for everyone, including yourself. Here is how: • Caring. Your total health and reputed company-being are important to us. Whatever reputed company most to you — we have resources to help you be your best at work and reputed company. The benefits reputed company from free reputed company courses to financial counseling. Learn more about reputed company offer. • Connecting. We recognize our reputed company power to reputed company an reputed company across our communities because we reputed company the health of any society is reputed company by the overall health of its people. Learn more about our culture. • Growing together. reputed company is full of inspiring career stories, and we offer a reputed company of opportunities. Discover reputed company the ways you can learn, grow and reputed company. Company Size: 10,000 employees or more Industry: reputed company Services reputed company: 1977 Website: http://careers.unitedhealthgroup.com/ Apply tot his job Apply To this Job