UnitedHealth Group is hiring

Clinical Quality Consultant II East TX job at UnitedHealth Group, Lufkin

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Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)

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 measures to 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
  • Develop solution-based, user friendly initiatives to support practice success
  • This position has extensive travel in the Dallas Market but allows you to work form home when you are not in the field. Field work is approximately 25%


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.

This position will be making visits to provider offices in the East Texas market.

$3,000 Sign-on Bonus for External Candidates!

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
  • 2+ years years HEDIS experience and/or knowledge  
  • Excellent knowledge of managed care requirements related to clinical quality
  • Excellent proficient with Microsoft Office applications, including: Word, Excel and PowerPoint
  • Ability to travel via car up to 25% of the time or more, depending on provider needs
  • Full COVID-19 vaccination is an essential requirement 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

Preferred Qualifications: 

  • Registered Nurse (within the states in which service is being delivered)
  • Significant Clinical and/or Health Education experience
  • Experience working with HEDIS software vendors (management, building relationships, issue resolution etc.)
  • Experience working with the CAHPS/HOS survey and/or patient satisfaction in care delivery
  • Experienced in medical record review
  • Proficiency with Microsoft Windows Suite (PPT, Excel, Word, Visio)
  • Basic statistical knowledge and application of continuous quality improvement concepts, such as Six Sigma, Lean, and/or PDSA
  • Excellent data management and/or project management skills
  • Demonstrated ability to assist with focusing activities toward a strategic direction and achieve targets
  • Excellent team development skills
  • Excellent interpersonal skills
  • Excellent time management and prioritization skills
  • Excellent written and verbal communications skills

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 WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.

**PLEASE NOTE** The Sign-On Bonus is only available to external candidates.  Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time, or per diem basis (“Internal Candidates”) are not eligible to receive a Sign On Bonus.


Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

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


Job country: United States

City: Lufkin

Category: Business Operations Specialists, All Other

Location: Lufkin, TX, United States

Job posted 2022-06-04

This job is expired

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