Remote Provider Enablement & Quality Improvement Advisor

Texas Health Institute; Phoenix, Northern (AZ, KY); Hybrid; USD 73,000 - 130,000; Full time

Benefits offered by this job

Paid Time Off

Medical Plan options

Dental, Vision, Life Insurance

Education Reimbursement

Job summary

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The Provider Enablement Consultant will oversee clinical management and quality for value-based programs, building relationships with behavioral health providers and driving improvement.

Based in the U.S. with fully remote work options, the PEC collaborates with Care Advocacy Operations and other teams to improve outcomes, efficiency, and contract compliance while communicating

Qualifications

• Active and unrestricted Master's degree-level clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling, Licensed Ph.D/Psy.D. level Psychologist, or Bachelor's level RN (licensure must be in state of residence)
• 3+ years post-licensure direct behavioral health clinical experience
• 1+ years of experience in a managed care setting
• 1+ years of experience performing analysis, reporting, and data analytics within healthcare
• Intermediate level of proficiency with Microsoft Office (Excel required)

Responsibilities

• Build and effectively maintain relationships with provider leadership and key clinical staff
• Regularly facilitate oversight meetings with providers to monitor, present, and discuss performance
• Monitor provider performance on program metrics, quality outcomes and adherence to contract requirements
• Identify performance improvement opportunities through analysis of operational data, clinical outcome data and utilization/claims data
• Communicate with providers to initiate interventions focused on improvement of clinical outcomes and efficiency, as well as compliance with contractual obligations
• Initiate and monitor Quality Improvement Plans to drive performance
• Conduct provider program audits and provide feedback and results
• Support high performing providers such that performance remains at a high level
• Provide clinical and care coordination support
• Deliver education and training
• Interface with other OHBS departments including Care Advocacy, Affordability, Clinical Network Services, Program and Network Integrity, and Quality Improvement

Skills

Clinical licensure

Behavioral health

Data analytics

Microsoft Excel

Education

Master's degree in psychology/social work

RN license (state of residence)

Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The Provider Enablement Consultant will oversee clinical management and quality for value-based programs, building relationships with behavioral health providers and driving improvement.

Based in the U.S. with fully remote work options, the PEC collaborates with Care Advocacy Operations and other teams to improve outcomes, efficiency, and contract compliance while communicating