Provider Engagement Lead Data-Driven Health Partnerships

Optum; Chattanooga (TN); Presencial; USD 73.000 - 130.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Descripción de la vacante

Optum is seeking a Senior Provider Engagement Specialist to act as a subject matter expert within Client Service operations. You will partner with provider groups and account managers to achieve operational and strategic goals by building information models and developing business solutions.

The role emphasizes data analysis, performance improvement, and cross-functional collaboration to drive revenue and quality outcomes.

Formación

• 5+ years of experience in a related medical field or health plan setting.
• Experience with Medicare health care operations including HEDIS, CMS reimbursement models.
• Experience developing long-term positive working relationships.
• Experience communicating and facilitating strategic meetings with groups of all sizes.
• Experience working independently, using good judgment and decision-making.
• Experience conducting performance evaluations to identify measures and actions for improvement.
• Proven knowledge of state and federal laws relating to Medicare.
• Proficiency in Microsoft Word, Excel and PowerPoint.
• Driver's license and willingness to travel up to 70%.

Responsabilidades

• Analyze risk pool and provider group performance to identify opportunities for improvement.
• Develop strategies and action plans aligning provider pools with company initiatives and quality outcomes.
• Drive processes and improvement initiatives impacting revenue and quality metrics.
• Use data to identify trends and opportunities; collaborate with colleagues and partners.
• Monitor utilization trends and assist with strategic plans to improve performance.
• Assists provider groups with investigating standard and non-standard requests and problems (claims, member services).
• Maintain solid day-to-day relationships with stakeholders to implement business solutions.

Conocimientos

Microsoft Word

Microsoft Excel

PowerPoint

Descripción del empleo

Optum is seeking a Senior Provider Engagement Specialist to act as a subject matter expert within Client Service operations. You will partner with provider groups and account managers to achieve operational and strategic goals by building information models and developing business solutions.

The role emphasizes data analysis, performance improvement, and cross-functional collaboration to drive revenue and quality outcomes.