TampaFLRecruiter Since 2001
the smart solution for Tampa jobs

HEDIS Clinical Quality Consultant - Tampa, FL

Company: UnitedHealth Group
Location: Tampa
Posted on: November 11, 2019

Job Description:

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.Based in Tampa, but will travel 75% locally to provider officesPrimary 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 successYoull 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:
    • 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 of Healthcare / Health Plan experience
    • 2+ years of HEDIS experience and/or knowledge
    • Strong data management and / or project management skills
    • Solid knowledge of managed care requirements related to clinical quality
    • Demonstrated ability to assist with focusing activities toward a strategic direction and achieve targets
    • Strong proficiency with Microsoft Office applications, including: Word, Excel and PowerPointPreferred Qualifications:
      • Significant Clinical and / or Health Education experience
      • Experience working with HEDIS software vendors (management, building relationships, issue resolution etc.)
      • 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 team development skills
      • Excellent time management and prioritization skills
      • Excellent written and verbal communications skillsPhysical & Mental Requirements:
        • Ability to lift up to 10 pounds
        • Ability to push or pull heavy objects using pounds of force Ability to sit for extended periods of time
        • Ability to stand for extended periods of time
        • Ability to use fine motor skills to operate office equipment and / or machinery
        • Ability to properly drive and operate a vehicle
        • Ability to receive and comprehend instructions verbally and / or in writing Ability to use logical reasoning for simple and complex problem solvingIf the hired individual resides in Florida (office based or ) this position requires the AHCA Level II background check (fingerprinting) by the State of Florida for all clinicians that have direct face to face contact with members OR employees who will have access to confidential patient data and will require renewal every five years.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 240,000+ 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)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.Job Keywords: CQC, Clinical Quality, Consultant, Medical Practice, HEDIS, STARS, Coach, education, Health plan, data management, Tampa, Polk, Hillsborough, Manatee, Florida

Keywords: UnitedHealth Group, Tampa , HEDIS Clinical Quality Consultant - Tampa, FL, Healthcare , Tampa, Florida

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Healthcare Jobs


Post-Acute Care - West Coast of Florida (Physician #)
Description: First Physicians Group of Sarasota Memorial Health Care System is looking to add a Board Certified or Board Eligible Internal Medicine or Family Medicine physician with experience and/or specialized training (more...)
Company: First Physicians Group of Sarasota Memorial Health
Location: Sarasota
Posted on: 11/15/2019

Urgent Care Opportunity - Southwest Florida (Sarasota area)!! (Physici
Description: Urgent Care opening in Sarasota, Florida. Urgent Care Opportunity - Southwest Florida Sarasota area br br The urgent care clinic network through the Hospital Medical Group is comprised of two (more...)
Company: DOCTORS CHOICE PLACEMENT SERVICES, INC.
Location: Sarasota
Posted on: 11/15/2019

New Graduate Nurse RN Residency Program
Description: Description SHIFT: Days rotating weekends br br SCHEDULE: Full-time br br br Join our HCA Nurse Residency Program Founded in 1967, Doctors Hospital ofSarasota is a 155-bed facility located (more...)
Company: Doctors Hospital of Sarasota
Location: Sarasota
Posted on: 11/15/2019


Medical Surgical Nurse
Description: Description br br SHIFT: Mixed rotating weekends br br SCHEDULE: Full-time br br Here at HCA Healthcare, our everyday decisions are founded on compassion. Apply today and join a team that (more...)
Company: Blake Medical Center
Location: Sarasota
Posted on: 11/15/2019

West Coast FL Opportunity - Sarasota, FL area!! (Physician #51269)
Description: West Coast FL Opportunity - Sarasota, FL area We need an experienced Board Certified IM or FP with an active Florida license who can start immediately This is a new, beautiful state of the art
Company: DOCTORS CHOICE PLACEMENT SERVICES, INC.
Location: Sarasota
Posted on: 11/15/2019

OB/GYN Hospital Employed - West Coast of Florida
Description: Obstetrics Gynecology opening in Sarasota, Florida. This and other physician jobs brought to you by DocCafe.com First Physicians Group of Sarasota Memorial Health Care System is seeking a Board-Certified (more...)
Company: First Physicians Group of Sarasota Memorial Health
Location: Sarasota
Posted on: 11/15/2019

Registered Nurse (RN) Cath Lab
Description: Description SHIFT: PRN br br SCHEDULE: PRN/Per Diem br br Become part of an awarding team of Registered Nurse---s here inthe--Cardiac Cath Lab--department at Doctor---s Hospital of Sarasota. (more...)
Company: Doctors Hospital of Sarasota
Location: Sarasota
Posted on: 11/15/2019

RN Medical Surgical (Ortho/Onc) - New RN Graduate
Description: Description br br SHIFT: Nights rotating weekends br br SCHEDULE: Full-time br br Are you looking for a company that places integrity over their bottom line Here at HCA, our everyday decisions (more...)
Company: Doctors Hospital of Sarasota
Location: Sarasota
Posted on: 11/15/2019

Internal/Family Medicine Physician Position in Beautiful Bradenton, FL
Description: We have an Immediate need for a Internal/Family Medicine Physician in Beautiful Tampa Bay FL. Our Quality group is growing so we have an opening in our facility.
Company: Medical On Demand
Location: Sarasota
Posted on: 11/15/2019

Cardiothoracic Surgeon Needed in the Sarasota, FL area!!
Description: Surgery-Cardiovascular opening in Sarasota, Florida. This and other physician jobs brought to you by DocCafe.com Cardiothoracic Surgeon Needed in the Sarasota, FL area Hospital is seeking a BE/BC cardiothoracic (more...)
Company: DOCTORS CHOICE PLACEMENT SERVICES, INC.
Location: Sarasota
Posted on: 11/15/2019

Log In or Create An Account

Get the latest Florida jobs by following @recnetFL on Twitter!

Tampa RSS job feeds