Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm)

The Clinical Program Consultant, Quality Education, Training and Regulatory Updates Team provides an education and training program for a team of staff that supports care delivery organizations within OptumCare. This role is responsible for creation of quality education materials, inclusive of performance measures within NCQA HEDIS and CMS Medicare Stars; best practice documents that support quality improvement strategies for these measures; and training materials that support quality processes and systems integral to quality functions such as provider point of care quality tools and supplemental data management systems.

The ideal candidate has solid expertise in quality measures, quality rating systems and the ability to interpret HEDIS and CMS Stars specifications and regulations to create educational and training material for internal and external customers. The candidate needs to be detailed oriented and able to take complex information and translate it into simpler context for educating others. This position will require experience in creating provider and member facing materials and experience in working in cross-functional teams and presenting to different types of audiences.

You’ll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Development of quality education content for internal staff, providers and members and ensuring quality education materials are up-to-date, professionally created, and optimize learning for markets and CP Quality organization
• Researching and development of best practice documents that support quality improvement strategies for provider and member initiatives to improve metrics
• Document repository management, intake of requests, and cloud-based sites
• Evaluating, updating and development of SOPs, workflows and job aids
• Management of NCQA PCS Q&A and ad-hoc trainings for annual and interim changes to CMS Stars and NCQA HEDIS quality measures
• Support and back-up for quality training and onboarding including quality systems such as supplemental data and primary source verification systems for CP Quality teams providing central services to our markets, and development and updating training materials
• Supporting director for HEDIS and Stars training
• Support director as a subject matter expert not only through development of quality materials but also as a consultant within the CP Quality organization and to our markets
• Participates in various cross-functional teams, committees and meetings at any level required to meet key business goals
  

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:

• High School Diploma or GED equivalent
• 5+ years of experience working with quality performance measures, quality rating systems, and quality improvement programs
• 2+ years of experience working with CMS Medicare Stars quality programs, inclusive of CAHPS, HOS, and NCQA HEDIS measures
• 2+ years of experience with quality improvement efforts focused on provider and member strategies, and data and analytic strategies
• 2+ years of expertise in NCQA HEDIS measures, including understanding of technical specifications for at least a subset of measures, and experience participating in annual review of changes
• 1+ years of experience presenting to executive teams and other layers of leadership within an organization
• Experience and knowledge of at least one other managed care population such as Medicaid or Commercial in addition to Medicare
• Experience with technology to develop educational materials, workflows and deliver presentations (e.g., Microsoft Office Word, PowerPoint, Visio, and Teams)
• Ability and willingness to travel both locally and non-locally up to 25%

Preferred Qualifications:

• Bachelor’s Degree
• Registered or Licensed Practical Nurse
• 2+ years of experience working in a quality department in a managed care organization, or in the quality department of a care delivery organization
• HEDIS chart abstraction experience
• Experience in provider facing role
• Experience establishing and maintaining effective working relationships with employees, managers, healthcare professionals, physicians and other members of senior administration and the general public
• Detailed oriented and excellent organizational skills
• Excellent verbal, written communication, presentation, and facilitation 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 Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

Colorado, Connecticut, Nevada, or New York City Residents Only: The salary range for Colorado residents is $82,100 to $146,900. The salary range for Connecticut/Nevada/New York City residents is $90,500 to $161,600. 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 employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. 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.

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.