Associate Practice Performance Manager - Northeast Alabama

UnitedHealth Group; Huntsville (AL); Hybrid; USD 60.000 - 107.000; Vollzeit

Benefits dieser Stelle

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Zusammenfassung

UnitedHealth Group's UnitedHealthcare division seeks an Associate Practice Performance Manager in Northeast Alabama. The role travels to provider offices to improve Medicare Advantage quality through Stars measures, data review, and education.

You will build relationships with physicians and groups, lead provider-specific improvement plans, and coordinate education and reporting. Remote work is possible for commutable candidates; travel up to 75% is required.

Qualifikationen

• 3+ years of healthcare industry experience.
• 1+ years with a health plan or provider office.
• Advanced Excel, Outlook and PowerPoint skills.
• Strong communication and presentation abilities.
• Proven relationship-building with clinical and non-clinical staff.

Aufgaben

• Travel across territory to meet providers and discuss Optum tools.
• Lead provider education and coaching on Stars measures and program administration.
• Review medical records to identify Star opportunities for staff.
• Coordinate data collection, quality monitoring and chart collection activities.
• Develop provider-specific plans to improve HEDIS outcomes.

Kenntnisse

Healthcare experience

Provider relations

Advanced Excel

Data analysis

Communication skills

Tools

EMR systems

Jobbeschreibung

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

The Associate Practice Performance Manager is responsible for program implementation and provider performance management which is tracked by designated provider metrics, inclusive minimally of 4 STAR gap closure and coding accuracy. The person in this role is expected to work directly with care providers to build relationships, ensure effective education and reporting, proactively identify performance improvement opportunities through analysis and discussion with subject matter experts; and influence provider behavior to achieve needed results. The person will review charts (paper and electronic - EMR), look for gaps in care, perform telephonic assessments for preventative screenings and/or HEDIS gaps in care, help coordinate doctor appointments, make follow-up calls to members after appointments, and assist our members in overall wellness and prevention. Work is primarily performed at physician practices on a daily basis. This position does not entail any direct member care* nor does any case management occur. (*with the exception of participating in health fairs and/or health screenings where member contact could occur).

*** Candidate must be available to travel up to 75% to provider offices throughout Northeast Alabama. ***

If you reside within a commutable distance from the Northeast Alabama area, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Functioning independently, travel across assigned territory to meet with providers to discuss Optum tools and programs focused on improving the quality of care for Medicare Advantage Members
• Execute applicable provider incentive programs for health plan
• Assist in the review of medical records to highlight Star opportunities for the medical staff
• Activities include data collection, data entry, quality monitoring, upload of images, and chart collection activities
• Locate medical screening results/documentation to ensure quality measures are followed in the closure of gaps. Will not conduct any evaluation or interpretation of Clinical data and will be supervised by licensed and/or certified staff
• Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs and ACOs
• Develop comprehensive, provider-specific plans to increase their HEDIS performance and improve their outcomes
• Provide ongoing strategic recommendations, training and coaching to provider groups on program implementation and barrier resolution
• Act as lead to pull necessary internal resources together in order to provide appropriate, effective provider education, coaching and consultation. Training will include Stars measures (HEDIS/CAHPS/HOS/med adherence), and Optum program administration, use of plan tools, reports and systems
• Coordinate and lead Stars-specific JOC meetings with provider groups with regular frequency to drive continual process improvement and achieve goals
• Provide reporting to health plan leadership on progress of overall performance, gap closure, and use of virtual administrative resource
• Facilitate/lead monthly or quarterly meetings, as required by plan leader, including report and material preparation
• Provide suggestions and feedback to Optum and health plan
• Work collaboratively with health plan market leads to make providers aware of Plan-sponsored initiatives designed to assist and empower members in closing gaps
• 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:

• 3+ years of healthcare industry experience
• 1+ years of experience working for a health plan and/or for a provider's office
• Microsoft Office specialist with exceptional analytical and data representation expertise; Advanced Excel, Outlook, and PowerPoint skills required
• Proven excellent communication and presentation skills
• Proven solid relationship building skills with clinical and non-clinical personnel

Preferred Qualifications:

• 1+ years of STARs experience
• Consulting experience
• Experience in managed care working with network and provider relations/contracting
• Solid knowledge of electronic medical record systems
• Solid knowledge of the Medicare market
• Knowledge base of clinical standards of care, preventive health, and Stars measures
• Proven medical/clinical background
• Proven solid problem-solving skills
• Proven solid financial analytical background within Medicare Advantage plans (Risk Adjustment/STARS Calculation models)

*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 $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are 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 and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.