Remote Medicaid Quality Improvement Consultant

Texas Health Institute; Northern (KY); Hybrid; USD 73,000 - 130,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Job summary

UnitedHealth Group is seeking a Clinical Practice Consultant to partner with physicians and Health Plan teams to improve Medicaid quality and outcomes across Washington State. This role emphasizes prevention, measure-specific initiatives, and education to close care gaps and align with state and federal requirements.

Travel up to 50% across Washington; remote work is available for residents of Washington. The incumbent will analyze claims data, monitor performance on HEDIS/State Measures, and

Qualifications

• 2+ years of Medicaid, managed care, care coordination, or clinical quality experience.
• 1+ years of experience working with healthcare data (claims, registries, care gaps, or reports).
• Proficiency with Windows and Microsoft Office applications.
• Willing and able to travel to physician offices across Washington up to 50%.
• Access to reliable transportation and a valid US driver's license.

Responsibilities

• Educates providers and office staff on clinical documentation, quality metrics specs and pay-for-performance measures.
• Supports program deployment at the practice level via partnerships with practitioners and staff.
• Serves as SME for HEDIS/State Measures and develops educational materials for offices.
• Represents the Health Plan at community events focused on quality improvement and health education.
• Identifies barriers to care and develops local strategies to close care gaps.
• Investigates gaps in documentation and monitors resolution to closure.
• Advises providers on standards of care and state-specific guidelines.
• Performs population data assessment and disease management per guidelines.
• Supports health equity and disparity reduction initiatives.

Skills

Medicaid experience

Healthcare data analysis

Windows proficiency

Travel willingness

Driver's license

Education

RN or clinical background (RN/LPN/MA)

Job description

UnitedHealth Group is seeking a Clinical Practice Consultant to partner with physicians and Health Plan teams to improve Medicaid quality and outcomes across Washington State. This role emphasizes prevention, measure-specific initiatives, and education to close care gaps and align with state and federal requirements.

Travel up to 50% across Washington; remote work is available for residents of Washington. The incumbent will analyze claims data, monitor performance on HEDIS/State Measures, and