Clinical Practice Consultant - Telecommute

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

The Clinical Practice consultant is responsible for completing auditing and/ or medical records review projects. Primary responsibilities will include data/ medical record collection (including outreach to provider offices) and medical record review. Additional responsibilities may include chart abstractions, reporting and analyses.

If you are located within a 1 hour commute to Warwick, RI, you will have the flexibility to telecommute* as you take on some tough challenges. 

Primary Responsibilities:

• Schedule and confirm individual appointments at provider offices/ facilities to access, review, and collect medical records that meet required HEDIS Technical Specifications

• Visit provider offices/ facilities to retrieve specific documents from medical records that meet required HEDIS Technical Specifications

• Scan and /or copy medical records as part of the retrieval process

• Facilitate the transfer of files to a secure file transfer site daily

• Participate in web-based trainings upon hire

• Complete and receive a passing score for all required training, testing and assessments

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:

• Undergraduate degree or equivalent experience (in healthcare data analytics, quality)
• Certified Professional in Healthcare Quality (CPHQ) Certification (if not already certified, commitment to get certified within the first 24 months of hire)
• 3+ years of Clinical Quality experience
• 3+ years of HEDIS experience
• 3+years of Medical record review experience 
• 3+ years of Provider and/ or Accountable Care Organization (ACO) outreach 
• 3+ years of Data analysis (able to identify trends and opportunities for improvement)
• Reliable transportation, auto insurance and a valid driver's license
• 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:

• Intermediate skills in Microsoft Word and Microsoft Excel (experience with combining and creating documents in Adobe Acrobat also preferred)

• Experience interfacing with United Health Services personnel and contracted providers/ physicians and their office staff

• Intermediate skills and willingness to learn how to use website portals/ processes for exchange of information

• High-speed internet access at home (no dial-up)

• Able to work well as part of a team and independently

• Able to travel to medical facilities/ provider offices to complete record reviews within a 40-mile radius

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 at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)

Connecticut Residents Only: The salary range for Nevada residents is $72,800 to $129,900. 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.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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.