Clinical Quality Consultant RN – Hybrid

Opportunities with ProHealth Physicians, part of the Optum family of businesses. When you work at ProHealth Physicians, your contributions directly sustain the health and well-being of our community. Discover high levels of teamwork, robust medical resources and a deep commitment to exceptional care and service. Join a leading community-based medical group and discover the meaning behind Caring. Connecting. Growing together.

 

Clinical Quality RN is responsible for reviewing, assigning tasks and closing incident reports in incident reporting platform. Analyzing and prepares reports related to incident reporting platform. Develop and implement risk management plans. Education and training on incident reporting for new and existing staff. 

 

If you are located in Farmington, Connecticut, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.

 

Primary Responsibilities:

• Serves as a key resource on complex incident review
• Reviews work performed by others and provides recommendation for improvement
• Evaluates clinical documentation related to incident reporting
• Educate, motivate, and/or influence others to understand the overall scope, overcome potential barriers, and engage in and commit to the process
• Communicate and explain applicable standards and/or technical specifications and identified gaps and/or changes in applicable standards
• Develop educational materials
• Work with others to ensure messaging to members and/or providers is appropriate to the audience
• Train others on relevant policies, rules, or regulations
• Serve as a resource providing explanations and expertise
• Develop understanding of customer requirements and/or expectations and anticipate needs to determine appropriate course of action-Develop audit or review processes
• Evaluate current processes, compare them to relevant standards or specifications and identify gaps in compliance or performance
• Work cross-functionally, making recommendations or clarifying information to assist in closing gaps that are identified or meeting customer expectations
• Work with auditors or key stakeholders for review/approval of results
• Develop and/or assist with corrective action plans based on audit findings or customer feedback
• Review processes and performance against customer expectations to provide needed information or service
• Other duties as assigned

 

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:

• Graduate of an accredited School of Nursing
• Current, unrestricted RN license in the state of Connecticut
• 1+ years of nursing experience
• Experience with Risk Management or equivalent

 

Preferred Qualifications:

• Experience with RLDatrix
• Experience with Microsoft Office: Excel, Outlook, Teams, Word, etc.
• EPIC experience

 

Connecticut Residents Only: The salary range for this role is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

 

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.

 

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.

 

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