UnitedHealth Group

UnitedHealth Group is a healthcare and well-being company that’s dedicated to improving the health outcomes of millions around the world. We are comprised of

Clinical Quality Consultant

Location

Florida + 4 moreAll locations: Florida | California | Minnesota | Texas | Washington

Posted

4 days ago

Salary

$112.7K - $193.2K / year

Seniority

Senior

No structured requirement data.

Job Description

Clinical Quality Consultant

UnitedHealth Group

Title: Clinical Quality Consultant - Oncogenetic Program - Remote Primary location: Dallas, TX Additional locations: Minneapolis, Minnesota | New York, New York | Los Angeles, California | Miami, Florida | Atlanta, Georgia | Houston, Texas | San Antonio, Texas | Seattle, Washington Requisition number: 2353640 Job category: Medical & Clinical Operations Overtime status: Exempt Travel: No Job Description: Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Clinical Quality Consultant for the Oncogenetic Program provides guidance and support for utilization management related to advanced molecular and genetic testing in oncology. This role ensures evidence-based decision-making, compliance with regulatory standards, and optimal patient outcomes through expert interpretation of genomic data and collaboration with multidisciplinary teams. The position requires experience in molecular pathology and oncogenetics, combined with demonstrated collaboration skills and the ability to thrive in a fast-paced, technology-driven environment. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Work to improve quality and promote evidence-based medicine - Ensure the right service is provided at the right time for each member - Work with medical director teams focusing on inpatient care management, clinical coverage review, member appeals clinical review, medical claim review and provider appeals clinical review 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: - PhD degree in molecular pathology, genetics, or similar - 5+ years of clinical experience in oncology or genetic medicine - Experience with genomic data interpretation software (e.g., NextGen sequencing analysis tools) - Knowledge of regulatory and compliance standards (CMS, NCCN, ASCO guidelines) for genetic testing and oncology care - Familiarity with molecular diagnostic coding systems and claims platforms - Proficiency in interpreting next-generation sequencing (NGS) and other advanced molecular diagnostic technologies - Proven ability to work effectively in a fast-paced, technology-driven environment - Proven ability to review work performed by others and provide recommendations Preferred Qualifications: - Hands-on utilization and/or quality management experience - Experience in using electronic clinical systems - Proven to serve as a key resource on complex molecular diagnostic cases - All employees working remotely 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 $112,700 to $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 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.

Related Categories

Related Job Pages

More Consultant Jobs

Health Coach

Public Health Solutions

Based in New York, New York, Public Health Solutions (PHS) is a nonprofit organization working to improve health outcomes for NYC families. It does so by provid

Consultant4 days ago

Title: Health Coach Location: New York United States Job Description: Company Overview: About Public Health Solutions Health disparities among New Yorkers are large, persistent, and increasing. Public Health Solutions (PHS) exists to change that trajectory and support underserved New Yorkers and their families to achieve optimal health and build pathways to reach their potential. As the largest public health nonprofit serving New York City, we improve health outcomes and help communities thrive by providing direct services to underserved families, supporting community-based organizations through our long-standing public-private partnerships, and bridging the gap between healthcare and community services. To learn more about our work, please visit healthsolutions.org. Program Description: In partnership with Stanford University, Public Health Solutions has been awarded a 5-year research grant from the Patient Centered Outcomes Research Institute (PCORI) focused on advancing maternal health equity. The goal of the CHIME study (Comparing Health Interventions for Maternal Equity) is to compare three different approaches to overcoming barriers to maternal healthy weight and chronic disease prevention. The community-based arm of the study will provide culturally relevant nutrition and physical activity and Health Coach support for pregnant and postpartum patients to improve maternal healthy weight in pregnancy and postpartum to prevent adverse maternal infant health outcomes. Summary of Position: PHS is seeking a health coach to fulfill the following duties: - Provide health education and home visiting services to pregnant participants throughout pregnancy and through 12- months postpartum. - Facilitate curriculum-based group health education workshops and support enrolled participants in the CHIME study with maternal & child health resources in their community. - Responsible for working with participants on their nutrition, physical activity, and lifestyle goal setting, as well as a detailed social needs screening, assessment, and referral. - Meet with participants on a weekly basis (at their home, in the office, or in the community) and keep detailed notes on their progress and activities, providing in-person support, text-message resources, and referrals to community services. - Manage caseload of up to 30 participants at a time and meet all stated program goals. - Follow guidelines from the Health Coach Manual on proper and in-depth case note documentation and tracking participant enrollment and progress in the study. - Regularly collaborates with program manager, study primary investigators (PIs), research coordinators, other team members, and nutrition/physical activity consultants to troubleshoot adverse events that may arise or discuss participants. This is a grant-funded position ending 6/30/30. Salary: $54,500.00 -$54,500.00 Qualifications and Requirements: - Preferred: Bachelor's degree in community/public health, social work, health coach, or related. - Experience: 1-2 years - Live in the tristate area (NY, NJ, CT), be willing to take public transportation or drive to home visits. - Bilingual preferred, but not required, in Spanish or Haitian Creole. - Demonstrated commitment to, and interest in learning more about maternal child health, systems approach to health equity, reproductive justice, racial justice, and community services in NYC. - Has experience with facilitating workshops or presenting health information in an engaging way to diverse audiences. - Prior experience with community-based outreach, conducting screening and wraparound services, and community engagement strategies preferred. - Ability to communicate effectively both orally and in writing with an attention to detail and professionalism in all communications. - Demonstrated strong interpersonal skills and respectful interactions with community members looking for services. - Must be comfortable conducting home visits in diverse neighborhoods and settings throughout NYC (i.e., homes, public housing, shelters, community centers, etc.). - Demonstrated experience performing administrative duties with speed and accuracy without immediate and constant supervision. - Must be highly organized and detail-oriented. - Collaborative spirit, seeking out how to be most helpful to the team. - Must interact well with staff and clients alike and have an outgoing personality. Benefits: - Hybrid Work Schedule. (i.e., 4 days in-person/community and 1 day work from home). This is subject to change based on program needs. - Generous Paid Time Off and Holidays. - An attractive and comprehensive benefits package including Medical, Dental and Vision. - Flexible Spending Accounts and Commuter Benefits. - Company Paid Life Insurance and Disability Coverage. - 403 (b) + employer matching and discretionary company contributions. - College Savings Plan. - Ongoing training and continuous opportunities for professional growth and development. At PHS, we place immense value on diversity within our teams, understanding that varied backgrounds and experiences significantly enhance our community and propel us toward our goals. If you find you don't have experience in all the areas listed above, we still encourage you to apply and share your background and experiences in your application. We are eager to discover how your unique perspective can bring positive transformations to our team and help advance our mission of creating healthier, more equitable communities. We look forward to learning more about you. PHS is proud to be an equal opportunity employer and encourages applications from women, people of color, persons with disabilities, LGBTQIA+ individuals, and veterans. 9:00am to 5:00pm 35 Hours per week

New York
$0 / year
Dein Einstieg bei der ]init[ AG logo

Consultant GKV-Digitalisierung

Dein Einstieg bei der ]init[ AG

Du möchtest die Gesellschaft von morgen mitgestalten? Dann bist du bei ]init[ richtig. Denn unsere digitalen Lösungen sind für Menschen gemacht und haben gesellschaftliche Relevanz. Klingt spannend? Dann steig ein und arbeite gemeinsam mit über 1.400 ]init[s in interdisziplinären Teams an unseren sieben Standorten – oder flexibel von überall in Deutschland aus.

Consultant4 days ago

Role Description Du kennst die Abläufe in einer gesetzlichen Krankenkasse aus der Praxis und möchtest die Digitalisierung der GKV aktiv mitgestalten? Dann bring deine Erfahrung aus Krankenkassenprozessen, Sozialversicherung, Softwareeinführung oder Prozessmanagement bei uns ein. - Du berätst eigenständig gesetzliche Krankenkassen und GKV-Dienstleister bei der Digitalisierung und Optimierung von Krankenkassenprozessen. - Du begleitest Projekte zur Prozessautomatisierung, Softwareeinführung und digitalen Transformation. - Du analysierst bestehende Fachprozesse (z. B. Krankenkassenprozesse, Versichertenprozesse, Leistungsprozesse oder Beitragsprozesse) in der gesetzlichen Krankenversicherung und entwickelst praxistaugliche Zielbilder. - Du übersetzt Anforderungen aus der GKV-Praxis in Fachkonzepte, User Stories, Prozessmodelle oder Umsetzungsvorgaben. - Du begleitest Kund:innen und Stakeholder:innen in Veränderungsprojekten / Change Management. - Du unterstützt Veränderungsvorhaben im klassischen, agilen oder hybriden Projektmanagement. - Du führst Workshops mit Fachbereichen, IT, Dienstleistern und Stakeholder:innen durch. Qualifications - Erfahrung mit Prozessen der gesetzlichen Krankenversicherung und Interesse an Digitalisierung. - Erfahrung mit Softwarelösungen, Fachverfahren oder digitalen Workflows im GKV-Umfeld. - Kenntnisse in Krankenkassen-Fachverfahren oder Plattformen wie BITMARCK/oscare, 21c|ng, ISKV_21c oder vergleichbaren Lösungen sind von Vorteil. - Beratende, strukturierte und kundenorientierte Arbeitsweise. - Fähigkeit, zwischen Fachbereich, IT und Projektteam zu übersetzen und Durchsetzungsvermögen. - Selbständige Arbeitsweise und Fähigkeit, eigenständig Lösungen zu finden. - Hohe Motivation, Flexibilität und Reisebereitschaft. Benefits - 30 Urlaubstage und flexible Arbeitszeiten. - Mobiles Arbeiten deutschlandweit - full-time oder im Teilzeitmodell. - Trainings und Weiterbildungen in der ]init[ Akademie. - Learning Lunches & Nutshells für abteilungsübergreifenden Austausch. - Bezuschussung deines ÖPNV-Tickets und kontinuierliche Entwicklung der Corporate Mobility Benefits. - Virtuelle Welcome Week für einen gelungenen Start. Company Description Du möchtest die Gesellschaft von morgen mitgestalten? Dann bist du bei ]init[ richtig. Denn unsere digitalen Lösungen sind für Menschen gemacht und haben gesellschaftliche Relevanz. Klingt spannend? Dann steig ein und arbeite gemeinsam mit über 1.400 ]init[s in interdisziplinären Teams an unseren sieben Standorten – oder flexibel von überall in Deutschland aus.

Germany
Zensar logo

ITSM SYSAID Tech Consultant/Admin

Zensar

At Zensar, we’re “experience-led everything”. We are committed to conceptualizing, designing, engineering, marketing, and managing digital solutions and experiences for over 130 leading enterprises. We are a company driven by a bold purpose: Together, we shape experiences for better futures. Whether for our clients, our people, or the world around us, this belief powers everything we do. At the heart of our culture is ONE with Client - a set of four core values that reflect who we are and how we work: One Zensar, Nurturing, Empowering, and Client Focus. Part of the $4.8 billion RPG Group, we’re a community of 10,000+ innovators across 30+ global locations, including Milpitas, Seattle, Princeton, Cape Town, London, Zurich, Singapore, and Mexico City. We believe the best work happens when individuality is celebrated, growth is encouraged, and well-being is prioritized. We are an equal employment opportunity (EEO) and affirmative action employer, committed to creating an inclusive workplace. All qualified applicants will be considered without regard to race, creed, color, ancestry, religion, sex, national origin, citizenship, age, sexual orientation, gender identity, disability, marital status, family medical leave status, or protected veteran status.

Consultant5 days ago
Full TimeRemoteTeam 10,001

Role Description - Design and implement ITIL processes in SysAid ITSM Tool (Incident, Change, Problem, Service Request, Knowledge, Configuration). - Hands-on experience with SysAid ITSM tool. - Knowledge of whole IT Service Management processes (Incident, Change, Problem, Service Request, Knowledge, Configuration) with strong understanding of ITIL framework. - Lead end-to-end implementation of SysAid ITSM solutions. - Configure modules in SysAid such as: - Incident Management - Service Requests - Problem & Change Management - Knowledge Management - Configuration Management - Integrate SysAid with: - Email systems - Network, database, and monitoring tools - Support CMDB setup and configuration. - Provide post-implementation support and enhancements. - Create documentation and knowledge base content. - Develop dashboards, reports, and KPIs. - Analyse service performance and recommend improvements. - Drive automation and process optimisation. Company Description At Zensar, we’re “experience-led everything”. We are committed to conceptualizing, designing, engineering, marketing, and managing digital solutions and experiences for over 130 leading enterprises. We are a company driven by a bold purpose: Together, we shape experiences for better futures. Whether for our clients, our people, or the world around us, this belief powers everything we do. At the heart of our culture is ONE with Client - a set of four core values that reflect who we are and how we work: One Zensar, Nurturing, Empowering, and Client Focus. Part of the $4.8 billion RPG Group, we’re a community of 10,000+ innovators across 30+ global locations, including Milpitas, Seattle, Princeton, Cape Town, London, Zurich, Singapore, and Mexico City. Explore Life at Zensar and join us to Grow. Own. Achieve. Learn. to be the best version of yourself. We believe the best work happens when individuality is celebrated, growth is encouraged, and well-being is prioritized. We are an equal employment opportunity (EEO) and affirmative action employer, committed to creating an inclusive workplace. All qualified applicants will be considered without regard to race, creed, color, ancestry, religion, sex, national origin, citizenship, age, sexual orientation, gender identity, disability, marital status, family medical leave status, or protected veteran status.

India

E-Commerce Consultant - ERP, D365

VTekis Consulting LLP

VTekis Consulting LLC provides complete solutions for Staff Augmentation, Recruitment Process Outsourcing, Contract Hiring, Direct Hire and Outsourced Solutions. Our goal is to deliver quality professional services to our clients not just to find someone to do a job, we match the right professional for your staffing needs and earning confidence through the proper assignment of people. This alignment of people and companies allows us to create opportunity. Most importantly, we don’t consider the process complete until we find the perfect fit.

Consultant5 days ago
ContractRemoteTeam 51-200

Role Description Required Experience: - 8-10 years in retail/e-commerce/ERP consulting, with 5+ years hands-on in D365 Commerce, F&O integration, and 3+ full-lifecycle implementations. - Delivered omnichannel projects for USA/India clients, including POS rollouts, headless e-commerce, and B2B portals with localization. - Experience in Agile delivery, global teams, and high-volume transaction environments. Skills and Qualifications: - Bachelor's/Master's in Business, IT, or related fields. - Microsoft certifications (MB-340 Commerce, MB-300, MB-310) a plus! - Expertise in D365 Commerce configuration, F&O linkages (sales/inventory/finance), and tools like Commerce HQ, Fabric, Power BI for retail analytics. - Strong process knowledge: order-to-cash, promotions, warranties, call center order capture. - Excellent communication for cross-functional workshops and documentation in global contexts. Behavioral Competencies: - Business-savvy innovator prioritizing OOTB over custom dev for scalable Commerce solutions. - Collaborative leader thriving in distributed USA/India teams with customer-centric focus. Qualifications - Bachelor's/Master's in Business, IT, or related fields. - Microsoft certifications (MB-340 Commerce, MB-300, MB-310) a plus! - Expertise in D365 Commerce configuration, F&O linkages (sales/inventory/finance), and tools like Commerce HQ, Fabric, Power BI for retail analytics. - Strong process knowledge: order-to-cash, promotions, warranties, call center order capture. - Excellent communication for cross-functional workshops and documentation in global contexts. Requirements - 8-10 years in retail/e-commerce/ERP consulting, with 5+ years hands-on in D365 Commerce, F&O integration, and 3+ full-lifecycle implementations. - Delivered omnichannel projects for USA/India clients, including POS rollouts, headless e-commerce, and B2B portals with localization. - Experience in Agile delivery, global teams, and high-volume transaction environments. Company Description We provide Recruitment and Staffing services to many industries and domain through our innovative and customized solutions and passionate commitment to research. Ability to understand the hiring strategies, availability of talent and compensation benchmarking makes us proud hiring partner for various industries. We work as trusted business partners and always strive to deliver the most value and highest return on investment for our clients. We are highly trained business professionals with strong understanding of clients need. We work closely with the leading staffing trade associations, training, and research organizations to ensure we are knowledgeable of industry trends and technologies.

United States