Job Description

**Optum is seeking APC Clinical Quality Consultants to join our HouseCalls team. Optum is a clinician-led care organization, that is creating a seamless health journey for patients across the care continuum.** At Optum, the integrated medical teams who practice within Home and Community Care are creating something new in health care. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while **Caring. Connecting. Growing together.** We are looking for some Advanced Practice Clinicians to join our Optum Clinical Quality Documentation and Review Team. You'll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges. **Position Highlights & Primary Responsibilities:** + Reviews documentation for both new and experienced Advanced Practice Clinicians (APCs) + Conducts weekly meetings with new APCs for the New Hire Clinical Quality Documentation Review + Supports initiatives aimed at improving quality of care + Collaborates with internal teams to promote and implement quality improvement efforts as a representative of the Clinical Quality Team + Participates in departmental projects as needed + Serves as a mentor and leader to peers and team members + Identifies trends and issues, and participates in monthly trend analysis meetings 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:** + Clinical APC or above with current, unrestricted license in state of residence + 5+ years of clinical experience + 3+ years of clinical quality and chart review experience + 3+ years working in managed care or in the insurance industry + 1+ years of experience with Medicare and/or Medicaid + 1+ years evaluating medical records with attention to detail to perform quality reviews + Proven solid organizational skills, self-motivated and ability to interact with company staff at all levels + Proven comprehensive knowledge of clinical standards of care, preventive health standards, STARs/HEDIS, and regulatory requirements. + Proficiency in software applications that include, but are not limited to, Microsoft Word, Microsoft Excel, Microsoft PowerPoint + Demonstrated ability to lead with strategic direction as well as develop tactical plans, drive performance and achieve targets + Proven ability to develop and present formal presentations in various settings including senior leaders + Proven solid organizational skills, self-motivated and ability to interact with company staff at all levels **Preferred Qualifications:** + Experience in meeting the medical needs of patients with complex behavioral, social and/or functional needs + Demonstrated understanding of Geriatrics and Chronic Illness + Experience leading projects within a highly matrixed organization Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

Job Tags

Minimum wage, Full time, Work experience placement, Local area,

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