Remote Provider Enablement & Quality Improvement Lead

Sustainable World, Inc.; Phoenix, Northern (AZ, KY); Hybrid; USD 73,000 - 130,000; Full time

Benefits offered by this job

Paid time off

8 paid holidays

Medical plan options

Dental, Vision, Life Insurance

401(k) and stock purchase plan

Education reimbursement

Employee discounts

Job summary

UnitedHealth Group is seeking a Provider Enablement Consultant (PEC) to oversee clinical management and quality oversight of value-based programs within Optum Behavioral Health. You will develop relationships with behavioral health providers and drive quality improvement to enhance outcomes and efficiency.

The PEC works with Care Advocacy Operations and other teams, travels as needed, and will communicate progress to Senior Leadership.

Qualifications

• Active and unrestricted Master's 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, Medicaid, and/or health & human services environment
• 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

Relationship-building

Communication skills

Excel

Data analytics

Written communication

Education

Master's degree in Psychology/Social Work/Counseling

State licensure (RN or psychologist)

Tools

Microsoft Excel

Job description

UnitedHealth Group is seeking a Provider Enablement Consultant (PEC) to oversee clinical management and quality oversight of value-based programs within Optum Behavioral Health. You will develop relationships with behavioral health providers and drive quality improvement to enhance outcomes and efficiency.

The PEC works with Care Advocacy Operations and other teams, travels as needed, and will communicate progress to Senior Leadership.