Clinical Practice Consultant -Southwest Virginia

UnitedHealth Group•Abingdon, VA

5d•$72,800 - $130,000•Remote

About The Position

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% 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.

Requirements

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% within the assigned market
Driver’s license and access to reliable transportation

Nice To Haves

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

Responsibilities

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
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