Provider Performance & Quality Improvement Lead

Texas Health Institute; Tigard (OR); Remote; USD 73,000 - 130,000; Full time

Job summary

UnitedHealthcare is seeking a Practice Performance Manager to lead program implementation and provider performance management, driving STARs gap closure and coding accuracy. The role collaborates with care providers to educate, report, and improve performance, with travel across the assigned territory and flexible Oregon remote work options.

Responsibilities include leading provider incentive programs, building long-term provider relationships, and developing provider-specific plans to improve

Qualifications

• 5+ years of healthcare industry experience.
• 3+ years in health plan or provider's office.
• 1+ years of STARs experience.
• Advanced Excel, Outlook and PowerPoint skills.
• Demonstrated solid communication and presentation skills.
• Demonstrated solid relationship building with clinical and non-clinical personnel.
• Weekly commitment of 60% travel for business meetings and 40% remote work.
• Driver's License and access to reliable transportation.

Responsibilities

• Functioning independently, travel across assigned territory to meet with providers to discuss UHG tools and programs focused on improving the quality of care for Medicare Advantage Members.
• Execute applicable provider incentive programs for health plan.
• 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.
• 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.
• Participate within department campaigns to improve overall quality improvements within measure star ratings or contracts.
• Work internally with leadership on adhoc projects, initiatives, and sprints to address measure star ratings and increase overall measure performance.
• Create strategy and action plans for targeted provider groups to increase healthcare delivery, star ratings, and maximize on gap closures.
• Weekly commitment of 60% travel for business meetings (including client/health plan partners and provider meetings) and 40% remote work.

Skills

Healthcare exp

STARs exp

Relationship building

Communication

Travel readiness

Tools

Microsoft Excel

Outlook

PowerPoint

Job description

UnitedHealthcare is seeking a Practice Performance Manager to lead program implementation and provider performance management, driving STARs gap closure and coding accuracy. The role collaborates with care providers to educate, report, and improve performance, with travel across the assigned territory and flexible Oregon remote work options.

Responsibilities include leading provider incentive programs, building long-term provider relationships, and developing provider-specific plans to improve