Is the Clinical Program Consultant - Remote in Western Washington State position at UnitedHealth Group fully remote?

Yes, this Clinical Program Consultant - Remote in Western Washington State position at UnitedHealth Group is a remote position. The role is available for candidates in United States.

What benefits does UnitedHealth Group offer for this position?

UnitedHealth Group offers the following benefits: Health Insurance, Equity.

Clinical Program Consultant - Remote in Western Washington State at UnitedHealth Group

United States

$72.8k - $130k

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing togetherThe Clinical Practice Consultant is a direct, provider-facing role, focused on improving clinical quality outcomes through measure specific initiatives and provider engagement. This role partners with providers and internal teams to support continuous quality improvement, including provider education, quality performance monitoring, medical record review, and collaboration across clinical and operational teams to improve outcomes and meet contractual and regulatory requirements.This position specializes in preventive health and condition management, working with providers and Health Plan staff to improve member health outcomes, close care gaps, and increase performance on state specific quality measures. The Clinical Practice Consultant supports the Medicaid adult population by coordinating, tracking, and improving compliance with quality and regulatory requirements in alignment with Washington State Medicaid (Apple Health) and federal guidelines. The role works closely with providers, clinical teams, quality, analytics, and community partners to identify gaps in care, monitor performance, and address barriers to care. This position integrates clinical knowledge, data review, and collaborative problem solving to improve health outcomes for members in Washington State.Up to 50%25 anticipated travel throughout Washington State. If you are located in Washington, you will have the flexibility to work remotely* as you take on some tough challenges.Primary Responsibilities:<ul style="margin-top:0in;" type="disc"><li class="MsoNormal" style="mso-list:l0 level1 lfo1;tab-stops:list .5in;">Educates providers and office staff on proper clinical documentation, state-mandated quality metrics specifications, provider profiling and pay for performance measurement, and medical record review criteria, to drive quality improvement</li><li class="MsoNormal" style="mso-list:l0 level1 lfo1;tab-stops:list .5in;">Supports effective deployment of program at the practice level through strategic partnerships with participating practitioners and practice staff while assessing trends in quality measures and identifying opportunities for quality improvement</li><li class="MsoNormal" style="mso-list:l0 level1 lfo1;tab-stops:list .5in;">Serves as subject matter expert (SME) for assigned HEDIS/State Measures, preventive health topics, leads efforts with clinical team to research and design educational materials for use in practitioner offices; serves as liaison with key vendors supporting HEDIS/State Measures; consults with vendors to design and implement initiatives to innovate and then improve HEDIS/State Measure rates</li><li class="MsoNormal" style="mso-list:l0 level1 lfo1;tab-stops:list .5in;">Participates, coordinates, and/or represents the Health Plan at community-based organization events, clinic days, health department meetings, and other outreach events focused on quality improvement, member health education, and disparity programs as assigned</li><li class="MsoNormal" style="mso-list:l0 level1 lfo1;tab-stops:list .5in;">Identifies population-based member barriers to care, identify local level strategies to overcome barriers and close clinical gaps in care</li><li class="MsoNormal" style="mso-list:l0 level1 lfo1;tab-stops:list .5in;">Investigates gaps in clinical documentation where system variation has impact on rate calculation, provides feedback to appropriate team members where issues are verified, and monitors resolution to conclusion</li><li class="MsoNormal" style="mso-list:l0 level1 lfo1;tab-stops:list .5in;">Works with providers on standards of care, and advises providers on established clinical practice guidelines, and appropriate documentation consistent with state specific measures and technical specifications</li><li class="MsoNormal" style="mso-list:l0 level1 lfo1;tab-stops:list .5in;">Performs population data assessment and disease management using a continuous quality improvement approach and approved clinical practice and disease management guidelines for the pediatric population</li><li class="MsoNormal" style="mso-list:l0 level1 lfo1;tab-stops:list .5in;">Supports health equity and disparity reduction strategies, including culturally responsive outreach and coordination with community-based organizations</li><li class="MsoNormal" style="mso-list:l0 level1 lfo1;tab-stops:list .5in;">Assist in resolving barriers to care such as access, scheduling, or follow-up needs  </li></ul>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:<ul style="margin-top:0in;" type="disc"><li class="MsoNormal" style="mso-list:l0 level1 lfo1;tab-stops:list .5in;">2+ years of experience in Medicaid, managed care, care coordination, or clinical quality  </li><li class="MsoNormal" style="mso-list:l0 level1 lfo1;tab-stops:list .5in;">1+ years of experience working with healthcare data (claims, registries, care gaps, or reports)  </li><li class="MsoNormal" style="mso-list:l0 level1 lfo1;tab-stops:list .5in;">Intermediate level of knowledge of one or more of: clinical standards of care, preventive health standards, HEDIS, NCQA, governing and regulatory agency requirements</li><li class="MsoNormal" style="mso-list:l0 level1 lfo1;tab-stops:list .5in;">Intermediate level of proficiency using a PC in a Windows environment, including Microsoft Outlook, Word, Excel, and PowerPoint</li><li class="MsoNormal" style="mso-list:l0 level1 lfo1;tab-stops:list .5in;">Willing and able to travel to physician offices locally up to 50%25 of the time throughout the state of Washington</li><li class="MsoNormal" style="mso-list:l0 level1 lfo1;tab-stops:list .5in;">Access to reliable transportation and & valid US driver's license</li></ul>Preferred Qualifications:<ul style="margin-top:0in;" type="disc"><li class="MsoNormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Current unrestricted RN or Clinical background such as RN, LPN, MA, or equivalent experience</li><li class="MsoNormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Experience in quality process improvement (lean, six sigma, etc)</li><li class="MsoNormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Experience with Washington State Medicaid (Apple Health)  </li><li class="MsoNormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Experience supporting provider alignment with state Medicaid quality requirements</li><li class="MsoNormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Experience supporting provider education or quality initiatives  </li><li class="MsoNormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Familiarity with HEDIS measures (e.g. CBP, CHL, FUA,)  </li><li class="MsoNormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Proven comfort working in fast-paced, evolving environments  </li><li class="MsoNormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Proven ability to interpret and translate health policy, guidance, and measure specifications into actionable provider education</li><li class="MsoNormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Proven solid communication, organizational, and follow-up skills  </li><li class="MsoNormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Proven ability to communicate effectively with broad audience: practice-level executive leadership, physicians, nurses, non-clinical office staff, and across the Health Plan</li><li class="MsoNormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Proven background in preventive health and condition management</li><li class="MsoNormal" style="mso-list:l1 level1 lfo2;tab-stops:list .5in;">Reside in Pierce, King or Thurston</li></ul><p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.<p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">    <p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;"><span class="TextRun SCXO255384946 BCX0 NormalTextRun" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;font-style:normal;font-variant-caps:normal;font-variant-ligatures:none !important;font-weight:400;letter-spacing:normal;line-height:20.7px;margin:0px;orphans:2;padding:0px;text-align:left;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;" data-contrast="auto" xml:lang="EN-US" lang="EN-US">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 hourly pay for this role will range $72,800 to $130,000 per hour based on full-time employment. This role is also eligible to receive bonuses based on sales performance. We comply with all minimum wage laws as applicable.<span class="EOP SCXO255384946 BCX0" style="-webkit-tap-highlight-color:transparent;-webkit-text-stroke-width:0px;-webkit-user-drag:none;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;line-height:20.7px;margin:0px;orphans:2;padding:0px;text-align:left;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;user-select:text;white-space:normal;widows:2;word-spacing:0px;"> <p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">    <p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.<p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">    <p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">    <p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">UnitedHealth Group 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.<p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">    <p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.<p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">    <p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:center;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">   <p style="-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:Tahoma;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;">#RPO #GREEN

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Remote Opportunity

Clinical Program Consultant - Remote in Western Washington State

Join UnitedHealth Group as a mid professional working remotely from United States. Explore the role, benefits, and apply in one place.

Clinical Program Consultant - Remote in Western Washington State

UnitedHealth Group

Full Time

$72.8k - $130k

3 weeks ago

United States

Engineering

Mid

Clinical quality improvement

Provider Engagement

HEDIS

+5 more

Job Description

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together

The Clinical Practice Consultant is a direct, provider-facing role, focused on improving clinical quality outcomes through measure specific initiatives and provider engagement. This role partners with providers and internal teams to support continuous quality improvement, including provider education, quality performance monitoring, medical record review, and collaboration across clinical and operational teams to improve outcomes and meet contractual and regulatory requirements.

This position specializes in preventive health and condition management, working with providers and Health Plan staff to improve member health outcomes, close care gaps, and increase performance on state specific quality measures. The Clinical Practice Consultant supports the Medicaid adult population by coordinating, tracking, and improving compliance with quality and regulatory requirements in alignment with Washington State Medicaid (Apple Health) and federal guidelines.

The role works closely with providers, clinical teams, quality, analytics, and community partners to identify gaps in care, monitor performance, and address barriers to care. This position integrates clinical knowledge, data review, and collaborative problem solving to improve health outcomes for members in Washington State.

Up to 50%25 anticipated travel throughout Washington State. If you are located in Washington, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

Educates providers and office staff on proper clinical documentation, state-mandated quality metrics specifications, provider profiling and pay for performance measurement, and medical record review criteria, to drive quality improvement
Supports effective deployment of program at the practice level through strategic partnerships with participating practitioners and practice staff while assessing trends in quality measures and identifying opportunities for quality improvement
Serves as subject matter expert (SME) for assigned HEDIS/State Measures, preventive health topics, leads efforts with clinical team to research and design educational materials for use in practitioner offices; serves as liaison with key vendors supporting HEDIS/State Measures; consults with vendors to design and implement initiatives to innovate and then improve HEDIS/State Measure rates
Participates, coordinates, and/or represents the Health Plan at community-based organization events, clinic days, health department meetings, and other outreach events focused on quality improvement, member health education, and disparity programs as assigned
Identifies population-based member barriers to care, identify local level strategies to overcome barriers and close clinical gaps in care
Investigates gaps in clinical documentation where system variation has impact on rate calculation, provides feedback to appropriate team members where issues are verified, and monitors resolution to conclusion
Works with providers on standards of care, and advises providers on established clinical practice guidelines, and appropriate documentation consistent with state specific measures and technical specifications
Performs population data assessment and disease management using a continuous quality improvement approach and approved clinical practice and disease management guidelines for the pediatric population
Supports health equity and disparity reduction strategies, including culturally responsive outreach and coordination with community-based organizations
Assist in resolving barriers to care such as access, scheduling, or follow-up needs

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:

2+ years of experience in Medicaid, managed care, care coordination, or clinical quality
1+ years of experience working with healthcare data (claims, registries, care gaps, or reports)
Intermediate level of knowledge of one or more of: clinical standards of care, preventive health standards, HEDIS, NCQA, governing and regulatory agency requirements
Intermediate level of proficiency using a PC in a Windows environment, including Microsoft Outlook, Word, Excel, and PowerPoint
Willing and able to travel to physician offices locally up to 50%25 of the time throughout the state of Washington
Access to reliable transportation and & valid US driver's license

Preferred Qualifications:

Current unrestricted RN or Clinical background such as RN, LPN, MA, or equivalent experience
Experience in quality process improvement (lean, six sigma, etc)
Experience with Washington State Medicaid (Apple Health)
Experience supporting provider alignment with state Medicaid quality requirements
Experience supporting provider education or quality initiatives
Familiarity with HEDIS measures (e.g. CBP, CHL, FUA,)
Proven comfort working in fast-paced, evolving environments
Proven ability to interpret and translate health policy, guidance, and measure specifications into actionable provider education
Proven solid communication, organizational, and follow-up skills
Proven ability to communicate effectively with broad audience: practice-level executive leadership, physicians, nurses, non-clinical office staff, and across the Health Plan
Proven background in preventive health and condition management
Reside in Pierce, King or Thurston

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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 hourly pay for this role will range $72,800 to $130,000 per hour based on full-time employment. This role is also eligible to receive bonuses based on sales performance. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

UnitedHealth Group 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.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO #GREEN

Benefits

Health Insurance
Equity

Skills

Clinical quality improvement

Provider Engagement

HEDIS

Medical Record Review

Care coordination

Data Analysis

Preventive health

Condition Management

Ready to Apply?

Join UnitedHealth Group today

Salary Range

$72.8k - $130k

Posted 3 weeks ago

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fundraising

Major gift solicitation

Donor Management

+5 more

Fundraising and External Relations Director

MedAmerica

Full Time

$102.29k - $130.42k

3 days ago

United States

Engineering

Backend Engineering

Staff

fundraising

Major gift solicitation

Donor Management

+5 more

Content Collection for Advertising Rescue Dogs - Volunteer (Unpaid)

Path of Hope Rescue

Part Time

3 days ago

Updated/Reviewed 12.04.25 Foster Dog Content Collection Job Industry: Charity / Social Services / Non- Profit Organization Position Name: Foster Dog Content Collection for Dog Rescue - Volunteer (Unpaid) Job Location: Spokane, Washington, United States Job Type: Part Time Office Setting: Fully…

United States

Marketing

Content Marketing

Entry

Content Collection

Data Organization

Communication

+5 more