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UnitedHealth Group InterQual Senior Clinical Education Consultant (RN) - U.S. Remote in Nashville, Tennessee

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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Optum, part of UnitedHealth Group (NYSE: UNH), is a leading information, technology-enabled health services, and software business dedicated to helping make the health system work better for everyone. We work with governments, employers, partners, and providers to care for over 146 million people and share a vision of a value-based system of care that provides compassionate and equitable care. With more than 190,000 people worldwide, Optum delivers intelligent, integrated solutions that help to modernize the health system and improve overall population health.

At Optum Insight (OI), we champion continuous innovation to provide software, network, and data analytics, technology-enabled services, advisory, and revenue cycle management offerings to help make health care work better for everyone.

UnitedHealthcare offers a full range of health benefits, enabling affordable coverage, simplifying the health care experience, and delivering access to high quality care. Our mission calls us, our values guide us, and our diverse culture connects us as we seek to improve care for the consumers we are privileged to serve and their communities.

Under the Director of InterQual Clinical Services' direction, the Senior Clinical Education Consultant will provide Clinical Education and Consulting to customers, as assigned, for InterQual Related Products, Programs and Platforms. The Senior Clinical Education Consultant interacts with appropriate internal and external contacts to ensure program coordination and knowledge of customer business and InterQual education needs. The Senior Clinical Education Consultant will provide education on services that will include IQCI, IQCER and RM Implementations clients, including InterQual Customize and or Coordinated Care as contracted.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

Customer Education and Consulting Services:

  • Prepares for and delivers education over multiple InterQual products, programs, services, and applications and helps integrate customer workflow or business processes with product functionality

  • Delivery of client education on all InterQual products, programs, and professional education courses. Programs will Include: InterQual Certified Instructor, InterQual Certified Expert Resource, Review Manager Implementations

  • Delivery of programs as an extension of the customer experience team include InterQual Customize and Coordinated Care

  • Works closely with Client Learning and Development team to update curriculum for specialized services noted above annually or more frequently if needed

  • Provides customized customer mentoring services to enhance the educational experience

  • Collaborates with Services, Product and Project Management and Technical teams to provide feedback for improved Customer experience, software, implementations, etc.

  • Consults with clients on InterQual education best practices, may require accessing customer system

  • Leverages cross-functional teams to identify issues and develop InterQual solutions that meet operational and customer objectives

  • Solves complex education issues as a subject matter expert

  • Documents each education session conducted within identified timeframe, ensuring notes are complete and concise, this ensures the organization can review services that were provided within the education department

  • Exercises independent judgment in developing methods, techniques, and evaluation criteria for obtaining results

Development and Maintenance of InterQual Programs and Services:

  • Assists in defining new service offerings working closely with the Director of InterQual Clinical Services Assists in the development of new programs and education delivery methods for all software programs that deliver InterQual

  • Exercises independent judgment in developing methods, techniques, and evaluation criteria for result oriented outcomes

  • Provides recommendations for new InterQual education materials that contain complex subject matter in conjunction with product management, software engineering or technical writers

  • Assists in developing and maintaining, InterQual education materials as assigned (case studies, competency exams/quizzes and/or exercises) to augment education sessions including education materials, and internal and external InterQual Toolkit

  • Coordinate updates to Client Learning and Development as needed to ensure education materials are up to date with content releases

  • Review of assigned InterQual IRR and or IQCI tests with direction from Clinical Quality Specialist, on an ongoing basis to ensure accuracy with updates from Clinical Development

  • Working with designated team members to develop and present materials for “Increase Your IQ” webinars as assigned

  • Maintains internal working relationships to understand evolution of features/functionality for new releases or enhancements

Maintaining and updating InterQual Programs and Services:

  • Working closely with the Client Learning and Development team to develop new education materials including new case studies

  • Assists and coordinates material updates to ensure accurate material use for internal and external education sessions, including IQCI, IQCER, Customization and Coordinated care

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:

  • Registered Professional Nurse with Active License

  • 6+ years of experience in utilization review/management, case management and or care management

  • Direct experience with InterQual products, programs and services

  • 6+ years of experience in adult education/training including presenting materials to varied groups of participants

  • Experience in healthcare hospital and or payer-based software

  • Demonstrated ability to work well within a fast-paced, team- oriented environment

  • Demonstrates a solid clinical background and Critical thinking skills

  • Potential for travel approximately 20% of the time

Preferred Qualifications:

  • Proven Presentation and Training skills

  • In-depth knowledge of technical training

  • Advanced knowledge of product and technical details

  • Knowledge of industry or industry background required (e.g., clinical)

  • Advanced experience with applicable tools (e.g., MS Office suite, LiveMeeting/Zoom/Webex, etc.)

  • Ability to effectively communicate with clinical, technical, and business staff

  • Consultative thought process and approach to customer issues

  • Ability to work independently within the role, taking on the responsibility of providing education daily

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $88,000 to $173,200 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.

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.

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.

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