Provider Performance & STARs Growth Lead

Stryker Corporation; Honolulu (HI); Hybrid; Confidential; Full time

Benefits offered by this job

Benefits package

Incentive programs

Equity stock purchase

401k contribution

Job summary

UnitedHealthcare is seeking a Practice Performance Manager to lead program implementation and provider performance management across Medicare Advantage. You will work with care providers to educate, report, and improve HEDIS and STAR measures while coordinating with internal teams to optimize outcomes.

The role requires extensive provider engagement, travel up to 60% across the territory and a mix of remote/work-from-office arrangements in Hawaii.

Qualifications

• 5+ years of healthcare industry experience.
• 3+ years of experience working for a health plan and/or for a provider's office.
• 1+ year of STARs experience.
• Proven solid communication and presentation skills.
• Proven solid relationship building skills with clinical and non-clinical personnel.
• Weekly commitment of 60% travel for business meetings (including client/health plan partners and provider meetings) and 40% remote work.

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.
• 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
• 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
• Works with less structured, more complex issues
• Serves as a resource to others

Skills

Communication

Presentation

Relationship building

Advanced Excel

PowerPoint

Outlook

MS Office

Tools

EMR systems

Job description

UnitedHealthcare is seeking a Practice Performance Manager to lead program implementation and provider performance management across Medicare Advantage. You will work with care providers to educate, report, and improve HEDIS and STAR measures while coordinating with internal teams to optimize outcomes.

The role requires extensive provider engagement, travel up to 60% across the territory and a mix of remote/work-from-office arrangements in Hawaii.