Clinical Program Consultant - Remote in Western Washington State

Clinical Practice Consultant The Clinical Practice Consultant is a direct, provider‑facing role focused on improving clinical quality outcomes through measure‑specific initiatives and provider engagement. The position specializes in behavioral health activities, coordinating compliance with Washington State Medicaid (Apple Health) and federal guidelines, and supporting the Medicaid population to improve health outcomes for children and adolescents. Up to 50% anticipated travel throughout Washington State. Telecommuting is available for candidates located in Washington State. Primary Responsibilities Support behavioral health activities and compliance with Washington Medicaid and federal behavioral health requirements through strategic partnerships with participating practitioners and practice staff while assessing trends in quality measures and identifying opportunities for quality improvement Educate providers and office staff on proper clinical documentation, state‑mandated quality metrics specifications, provider profiling and pay‑for‑performance measurement, and medical record review criteria, to drive quality improvement Advise providers on state‑specific behavioral health periodicity schedules, documentation expectations, and compliance considerations Participate, coordinate, and/or represent the Health Plan at community‑based organization events, clinic days, health department meetings, and other outreach events focused on quality improvement, member health education, and disparity programs as assigned Identify members due or overdue for behavioral health services and assist with outreach initiatives Collaborate with maternal‑child health, care management, behavioral health, and community outreach teams to address unmet behavioral health diagnostic or treatment needs Support health equity and disparity reduction strategies specific to Medicaid populations, including culturally responsive outreach and coordination with community‑based organizations Serve as a resource for providers related to behavioral health requirements and documentation Assist in resolving barriers to care such as access, scheduling, or follow‑up needs Support audits, reporting, and quality improvement activities related to behavioral health Required Qualifications 2+ years of experience in Medicaid, managed care, care coordination, or clinical quality 1+ years of experience working with healthcare data (claims, registries, care gaps, or reports) Intermediate level of knowledge of behavioral health, pediatric, adolescent or adult preventive services Intermediate level of knowledge of one or more: clinical standards of care, preventive health standards, HEDIS, NCQA, governing and regulatory agency requirements Intermediate level of proficiency using a PC in a Windows environment, including Microsoft Outlook, Word, Excel, and PowerPoint Willing and able to travel to physician offices locally up to 50% of the time within Washington Access to reliable transportation and valid US driver's license Preferred Qualifications Associate's or Bachelor's degree in healthcare, public health, or related field (or equivalent experience) Current unrestricted RN or Clinical background such as RN, LPN, MA, or equivalent experience Experience in quality process improvement (lean, six sigma, etc.) Experience with Washington State Medicaid (Apple Health) Ability to interpret and translate behavioral health policies, guidance, and measure specifications into actionable provider education Familiarity with behavioral health HEDIS measures Knowledge of behavioral health screening tools (e.g., developmental, behavioral, social determinants) and referral workflows Experience supporting provider alignment with state Medicaid pediatric quality requirements Experience supporting provider education or quality initiatives Comfort working in fast‑paced, evolving environments Strong communication, organizational, and follow‑up skills Proven ability to communicate effectively with broad audience: practice‑level executive leadership, physicians, nurses, non‑clinical office staff, and across the Health Plan All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including local labor markets, education, work experience, and certifications. Salary range for this role is $72,800 to $130,000 annually for full‑time employment. Benefits include a comprehensive benefits package, incentive and recognition programs, an equity stock purchase plan, and 401(k) contribution. All benefits are subject to eligibility requirements. 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. #J-18808-Ljbffr Stryker Corporation