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We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM


Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com


Job Category:



United States

Postal Code:


Approximate Salary:

Not Specified

Position Type:

Full Time

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Registered Nurse, RN, Clinical Quality Consultant, HEDIS / STARS - San Antonio, TX


Posted: 09/2/2018

For 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)


This role is responsible for effective delivery of training of HEDIS/STAR programs across the organization.  The Quality Training Lead keeps abreast of various training delivery techniques, business processes, products and systems. This role assists in the designing, managing, implementing and evaluating of training of Quality programs to prepare high quality and highly competent staff for meaningful contributions in the workplace.  This position will work with Quality training for new employee on-boarding, clinical orientation/training related to the Quality department, HEDIS and audit modules, staff competencies, and any new training initiatives.  This position facilitates training to all new quality department members.  This position also works with a Quality Manager to ensure successful execution of training materials.


Primary Responsibilities:

  • Implements staff development and clinical staff competency programs incorporating appropriate adult learning principles
  • Conducts Quality  training and education programs for providers, clinic staff, and  administrative departments, as assigned
  • Provide training on HEDIS/Star Measures, preventive health topics
  • Provide training to the clinical team to research and design educational materials for use in practitioner offices; serves as liaison with key vendors supporting HEDIS/Star Measures; consults with vendors to design and implement initiatives to innovate and then improve HEDIS/Star Measure rates  
  • Follows plan for professional development and actively seeks out opportunities to increase expertise in health care education and quality  training programs    
  • Work with instructional design staff to ensure all new initiatives, policies and procedures, guidelines, or other necessary updates are incorporated into orientation/training programs
  • Identify innovative training strategies for learners, including distance learners
  • Leverages creativity and utilizes a wide variety of methods to present education and training programs
  • Designs practice level quality transformation through targeted clinical education and approved materials related to HEDIS/State Specific quality measures for provider and staff education during field visits
  • Educate the staff on  proper clinical documentation, coding, and billing practices, state-mandated quality metrics specifications, provider profiling and pay for performance
  • Evaluate the results of post-program surveys and processes to obtain participant feedback
  • Conduct competency skill evaluations at least yearly to ensure ongoing monitoring of skills and performance
  • Educate the staff on how to  Investigates gaps in clinical documentation where system variation has impact on rate calculation, and how to  provide effective  feedback to providers and appropriate departments
  • Provides job role training to learners for specific behavior and skill development utilizing effective feedback and motivational support techniques
  • Collaborate with learner's manager and the instructional design team to identify and provide training needs for staff
  • Provide learner specific feedback and recommendations to learner's manager
  • Follows plan for professional development and actively seeks out opportunities to increase expertise in nursing education and adult training programs
  • Provides excellent customer service, monitors quality service and customer service delivery by nursing staff
  • Serves on corporate committees, task forces, and/or work groups
  • Performs all other related duties as assigned

Please note: This is an office based position located at our office off of Northwest Parkway in San Antonio, TX. The position requires 35% travel in the TX and FL areas

Required Qualifications:

  • Bachelor of Science in Nursing, Healthcare Administration, Education or a related field required (4 additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor's degree)
  • Current Registered Nurse (RN) license in the state of residence
  • 5+ years of experience in managed care and/or disease management, as well as experience in a clinical setting, hospital or physician office practice
  • Knowledge base of clinical standards of care, preventative health, and Star measures
  • Problem-solving and decision-making skills
  • Proficiency with Microsoft Office applications
  • For Centralized Quality Business Unit - Some travel to all markets (Texas and Florida, for example) required, with occasional overnight travel

Preferred Qualifications:

  • Knowledge of the managed care, disease management and complex care case management, basic principles and practices of clinical nursing, adult learning principals
  • Experience with an electronic medical record documentation
  • Business experience within the  health care industry including at least 1 year of experience with HEDIS/Stars
  • Experience presenting education of HEDIS/Stars material to providers and provider office staff
  • Strong communication and presentation skills
  • Strong relationship building skills with clinical and non-clinical personnel
  • Demonstrated ability to interact with medical staff, peers, and internal company staff at all levels
  • Training experience
  • Strong knowledge of the Medicare market, products and competitors

Physical & Mental Requirements:

  • Ability to lift up to 25 pounds
  • Ability to push or pull heavy objects using up to 25 pounds of force
  • Ability to sit for extended periods of time
  • Ability to stand for extended periods of time
  • Ability to receive and comprehend instructions verbally and/or in writing
  • Ability to use logical reasoning for simple and complex problem solving

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 240,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)


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.



Job Keywords: WellMed, Healthcare, Bilingual, Registered Nurse, RN, Clinical Educator, Quality Training Lead, HEDIS/STAR, Consultant, San Antonio, New Braunfels, Seguin, Gonzales, Shiner, Yoakum, Boerne, Floresville, Helotes, Texas, TX

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