Clinical Practice Performance Consultant - Remote in MD

The Clinical Practice Performance Consultant is responsible for developing clinically oriented provider and community-based partnerships to enhance HEDIS quality scores and state-specific quality measures. This role involves managing provider practice quality measures and supporting NCQA accreditation compliance.

• Pay: $72,800 - $130,000/year
• Location: Columbia, MD
• Schedule: Full Time, Day shift
• Residency: Must reside in Maryland

• Develop clinically oriented partnerships to increase HEDIS quality scores.
• Manage provider practice quality measures and HEDIS medical record collection.
• Coordinate with the Quality Field Operations manager for provider performance improvement.
• Analyze and review quality outcomes at the provider level.
• Assist providers in meeting quality standards and state contractual requirements.
• Drive clinical relationships with physician practices, members, and pharmacies.
• Identify performance improvement opportunities through data analytics.
• Educate providers on clinical documentation, coding, and billing practices.
• Conduct onsite clinical evaluations through medical record audits.
• Support member care by identifying needs for health education and services.

Education:

• Current unrestricted LPN or RN licensure required in the state of Maryland or ability to obtain licensure.

Experience:

• 5+ years clinical experience.
• 2+ years of quality improvement experience.

Licenses &

Certifications:

• Current RN License in Maryland required.

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase and 401k contribution.

United Health Group is a leading healthcare provider committed to delivering exceptional patient care. They focus on simplifying the health care experience and creating healthier communities while removing barriers to quality care.