RN, Clinical Quality Consultant - Onsite in San Antonio, local

RN, Clinical Quality Consultant - Onsite in San Antonio, with local Travel at Optum summary:

The RN, Clinical Quality Consultant at Well Med/Optum in San Antonio is responsible for driving quality improvement initiatives to achieve and maintain a minimum 4 STAR rating across provider networks. This role involves interpreting healthcare quality data, developing business plans, training materials, and collaborating with regional teams to enhance Medicare Advantage performance. The position requires strong clinical knowledge, analytical skills, and the ability to communicate effectively with healthcare providers while supporting preventive care and managed care programs.

Well Med, part of the Optum family of businesses, is seeking a RN, Clinical Quality Consultant to join our team in San Antonio, TX. Optum is a clinician-led care organization that is changing the way clinicians work and live.

As a member of the Optum Care Delivery team, you’ll be an integral part of our vision to make healthcare better for everyone.

At Optum, you’ll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and erience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country.

Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

The Clinical Quality Consultant will drive consistency, efficient processes and share best practices – in a collaborative effort with the providers – designed to facilitate a minimum 4 STAR rating. The CQC will participate in quality improvement initiatives, 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.

Position Highlights & 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
• Assist in developing of training and analytical materials for Stars and HEDIS
• 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
• Focus communications and efforts accordingly
• Develop solution-based, user friendly initiatives to support practice success

In 2011, Well Med partnered with Optum to provide care to patients across Texas and Florida. Well Med is a network of doctors, specialists and other medical professionals that specialize in providing care for more than 1 million older adults with over 16,000 doctors’ offices. At Well Med our focus is simple. We’re innovators in preventative health care, striving to change the face of health care for seniors.

Well Med has more than 22,000+ primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000+ older adults. Together, we're making health care work better for everyone.

You’ll be rewarded and recognized for your performance in an environment that will challenge you…