Provider Performance & STARs Improvement Lead

Cim; Honolulu, Northern (HI, KY); Hybrid; USD 73,000 - 130,000; Full time

Benefits offered by this job

Comprehensive benefits package

401k contribution

Equity stock purchase program

Incentive and recognition programs

Remote work flexibility

Job summary

UnitedHealthcare is hiring a Practice Performance Manager to drive program implementation and provider performance management, with emphasis on improving STARs gap closure and coding accuracy.

The role involves building relationships with care providers, delivering education and reporting, and identifying performance improvement opportunities through data analytics and collaboration with internal subject matter experts.

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.
• 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.

Skills

Healthcare industry experience

STARs experience

Communication skills

Relationship building

Travel willingness

Job description

UnitedHealthcare is hiring a Practice Performance Manager to drive program implementation and provider performance management, with emphasis on improving STARs gap closure and coding accuracy.

The role involves building relationships with care providers, delivering education and reporting, and identifying performance improvement opportunities through data analytics and collaboration with internal subject matter experts.