Clinical Practice Consultant -Southwest Virginia

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 equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The Clinical Practice Consultant (CPC) is a direct, provider facing role responsible for supporting physician practices through targeted clinical quality improvement initiatives. This position partners closely with providers to improve performance on state and federal quality measures, close care gaps, and support compliance with contractual and regulatory requirements.

This role reports to the Associate Director of Clinical Quality and collaborates with internal and external stakeholders to drive sustainable improvements in provider’s performance.

If you reside within a commutable distance of Southwest Virginia, you will have the flexibility to work remotely while engaging in up to 75%25 same-day travel to provider locations.

 * Ideal candidates will be located within Virginia and near Russell, Smyth, Tazewell, or Washington counties.

This is a Field Based position with a Home-Based Office.

Primary Responsibilities:

• Operational & Program Support:
  • Serve as a subject matter expert (SME) for assigned HEDIS/State Measures and preventive health topics
  • Support state specific medical record retrieval and quality initiatives as directed by Quality Leadership
  • Review medical records and internal systems to identify and address open care gaps
  • Assist with development of SOPs, job aids, and educational materials for internal and external use
  • Represent the health plan at provider meetings, clinic days, and community or public health focused events
  • Identify opportunities to improve operational efficiency and effectiveness
  • Perform additional duties supporting quality programs and health plan initiatives as needed
• Provider & Practice Support:
  • Develop strong relationships with targeted provider groups to drive improvement in clinical quality performance
  • Serve as a trusted liaison between providers and internal teams, to address operational, network, claims, and service-related needs to enhance the provider experience
  • Analyze large volumes of clinical data, translate findings into actionable opportunities for providers, and track interventions through completion
  • Apply creative strategies to engage providers
  • Conduct medical record audits to assess documentation, coding, and billing practices
  • Assess performance trends and deliver targeted clinical, quality, and coding best practices to support quality outcomes
  • Lead year-round medical record retrieval, review, and submission activities to support care gap closure

  • Anticipate, understand, and address the needs of internal and external stakeholders

     

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:

• 3+ years of clinical or clinical quality experience
• Intermediate level of proficiency with Microsoft Word, Excel, and PowerPoint
• Intermediate level of proficiency using multiple systems/applications simultaneously
• Willingness and ability to travel up to 75%25 within the assigned market
• Driver’s license and access to reliable transportation

Preferred Qualifications:

• Current unrestricted RN or clinical background (RN, LPN, MA, or equivalent experience)
• 2+ years of clinical quality improvement experience
• Experience supporting Primary Care Practices

Soft Skills:

• Ability to communicate effectively with diverse audiences including physicians, executive leadership, clinical and non‑clinical staff
• Ability to make formal presentations within the context of their role
• Proven verbal, written, and presentation skills

*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 salary for this role will range from $72,800 to $130,000 annually based on full-time employment. 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.

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