Associate Practice Performance Manager - Remote in Indiana

UnitedHealth Group; Indianapolis (IN); Hybrid; Confidential; Full time

Job summary

A leading company in healthcare is seeking an Associate Practice Performance Manager to enhance quality of care for Medicare Members across Indiana. This role involves direct engagement with providers, performance analysis, and implementing improvement strategies. Ideal candidates will have strong healthcare industry experience and the ability to foster long-term relationships with medical professionals. The position offers the flexibility of remote work while facilitating travel in the assigned territory.

Benefits

Comprehensive benefits package

Incentive and recognition programs

401k contribution

Qualifications

• 3+ years of healthcare industry experience
• 1+ years of experience working for a health plan
• Proven solid knowledge of electronic medical record systems

Responsibilities

• Manage provider performance through relationship building and performance analysis.
• Conduct assessments for preventative screenings and HEDIS gaps.
• Drive continuous improvement in provider quality of care metrics.

Skills

Healthcare industry experience

Relationship building

Analytical skills

Communication skills

Data collection and entry

Tools

Microsoft Office

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 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.

If you are located in Indiana, 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. – May require onsite work with providers
• Establish positive, long-term, consultative relationships with physicians, medical groups
• 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 monthly 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

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 experience
• Ability to travel approximately 75% of the time in the assigned regional area as business needs dictate must live in Indiana to perform the travel requirements of this role
• Must be able to provide proof of a valid, unrestricted Driver’s License, access to reliable transportation and current auto insurance
• Reside in Indiana

Preferred Qualifications:

• LPN or Medical Assistant
• Pharmacy Technician
• 1+ year of STARs experience
• 1+ years of experience in account management or sales, preferably in the healthcare or insurance industry
• Account management and/or sales experience
• Medical/clinical background
• Proven solid communication and presentation skills
• Proven solid relationship building skills with clinical and non-clinical personnel
• Proven solid knowledge of electronic medical record systems
• Consulting experience
• Proven solid knowledge of the Medicare market
• Proven knowledge base of clinical standards of care, preventive health, and Stars measures
• Experience in managed care working with network and provider relations/contracting
• Demonstrated solid financial analytical background within Medicare Advantage plans (Risk Adjustment/STARS Calculation models)
• Microsoft Office specialist with exceptional analytical and data representation expertise; Advanced Excel, Outlook, and PowerPoint skills

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

The salary range for this role is $59,500 to $116,600 annually based on full-time employment. 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.

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.