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Clinical Adherence Consultant – Telecommute

UnitedHealth Group

This is a Full-time position in Eden Prairie, MN posted March 2, 2021.

nnFor those who want to invent the future of health care, here’s your opportunity.

We’re going beyond basic care to health programs integrated across the entire continuum of care.

Join us and help people live healthier lives while doing your life’s best work.(sm) nn nnThe Clinical Adherence Consultant role is an individual contributor role that supports all aspects of the Clinical Adherence and Remediation program across a matrixed team.

The Clinical Adherence and Remediation team is responsible for driving a standardized business process adherent to delegated regulatory, accreditation, and enterprise requirements across the CDOs.

This role requires development of relationships across many levels of functional business leaders, as well as an understanding of the functional business structure and the ability to drive business goals with matrix partners across Optum, Optum Care, and payors.nn nnYou’ll enjoy the flexibility to telecommute* from anywhere within the U.S.

as you take on some tough challenges.nn *This is a telecommute role and candidates must be able to work 8:00am
– 5pm CST to meet the business need.* nn nn Primary Responsibilities: nn Provide program support to the matrixed organization on regulatory adherence issues Support and communicate the comprehensive functional clinical adherence and remediation strategy and support the business leader(s) in implementing that strategy Drive improved adherence outcomes in top risk areas Support the future vision of the adherence program and be able to explain how current decisions/processes impact the chance to achieve / reach it Work with the business to prevent non-adherence issues from occurring; monitors with the business to detect issues and corrects those issues when detected through internal and payor monitoring as well as federal/state/regulatory/delegation audits Influence and collaborate within a matrixed Compliance, Legal and Regulatory team and with highly matrixed business partners across UHC, Optum and Optum Care Collaborate with the business to review, analyze and develop/oversee initial implementation project plans and/or corrective action plans to ensure adherence to new or existing laws and regulations and company, customer and accreditation requirements Engage in and lead escalated issues of non-adherence that impact functional areas Interpret regulatory or legal information and publications and support distilling into actions as needed Identify training needs for CDOs and support the training initiatives and provide subject matter expertise related to delegated medical management Conduct assessments of policies and procedures and case files according to federal, state, accreditor, and payor requirements to evaluate compliance/adherence to standards Participate in and support implementation of delegated activities across CDOs Perform policy and procedure annual review and revision for central set of Optum policy and procedures related to delegation and map policy and procedures to payor assessment requirements nnYou’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.nn nnRequired Qualifications:nn Active nursing license Undergraduate degree 3+ years’ experience in healthcare 3+ years in managed care or medical group Experience in compliance or health plan regulatory adherence Experience working with Government and Non-Government Programs (Medicare, Medicaid, and Commercial) and/or accreditations Experience writing, reviewing and/or revising policy and procedures If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener.

When in a UnitedHealth Group building, employees are required to wear a mask in common areas.

In addition, employees must comply with any state and local masking orders nn Preferred Qualifications: nn Master’s degree preferred
– MBA, MHA, Nursing or related field Ability to navigate and influence a complex matrixed environment and drive to resolution Above average skills in thinking strategically and to translate strategic directives into tactical initiatives Excellent verbal and written communication; problem solving Collaborate, take accountability and lead teams Work within a matrix organization, accomplishing work through influence and dotted line matric support Develop and introduce innovative ideas and change into a large complex organization Make decisions even when information is limited or unclear Deal with ambiguity – can effectively cope with change, can shift gears comfortably, can decide and act without having the total picture, comfortably handles risk and uncertainty in a manner consistent with UnitedHealth Groups core values, culture and common language of leadership Travel approximately 5-10% Solid team player with demonstrated interpersonal and customer service skills Self-starter and ability to understand the “why” and leverage that understanding to drive to solutions and mitigation plans nn nn nnCareers with Optum. Here’s the idea.

We built an entire organization around one giant objective; make health care work better for everyone.

So when it comes to how we use the world’s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve.

Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential.

For you, that means working on high performance teams against sophisticated challenges that matter.

Optum, incredible ideas in one incredible company and a singular opportunity to do your life’s best work.(sm)nn nnThe salary range for Colorado residents is $79,700 to $142,600.

Pay is based on several factors including but not limited to education, work experience, certifications, etc.

As of the date of this posting, In addition to your salary,  UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.nn nn*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policynn nn nn Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.nn UnitedHealth Group is a drug-free workplace.

Candidates are required to pass a drug test before beginning employment.nn nn nn nnJob Keywords: Clinical Consultant, Clinical Adherence, Clinical Adherence Consultant, Eden Prairie, MN, Minnesota, Telecommute, Telecommuter, Telecommuting, Work from home, Work at home, Remotenn

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