Field Based Associate Practice Performance Manager - Washington, DC

Employer
UnitedHealth Group
Location
Chevy Chase, MD
Posted
Dec 07, 2022
Closes
Dec 10, 2022
Ref
726369468
Industry
Healthcare
Hours
Full Time
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life s best work. SM The Associate Practice Performance Manager is responsible for program implementation and provider performance management which is tracked by designated provider metrics, inclusive minimally of 4 STAR gap closure and coding accuracy. The person in this role is expected to work directly with care providers to build relationships, ensure effective education and reporting, proactively identify performance improvement opportunities through analysis and discussion with subject matter experts; and influence provider behavior to achieve needed results. The person will review charts (paper and electronic - EMR), look for gaps in care, perform telephonic assessments for preventative screenings and/or HEDIS gaps in care, help coordinate doctor appointments, make follow-up calls to members after appointments, and assist our members in overall wellness and prevention. Work is primarily performed at physician practices on a daily basis. This position does not entail any direct member care* nor does any case management occur. (*with the exception of participating in health fairs and/or health screenings where member contact could occur) Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm. Primary Responsibilities: Functioning independently, travel across assigned territory to meet with providers to discuss Optum tools and programs focused on improving the quality of care for Medicare Advantage Members. Execute applicable provider incentive programs for health plan. Assist in the review of medical records to highlight Star opportunities for the medical staff. Activities include data collection, data entry, quality monitoring, upload of images, and chart collection activities. Locate medical screening results/documentation to ensure quality measures are followed in the closure of gaps. Will not conduct any evaluation or interpretation of Clinical data and will be supervised by licensed and/or certified staff 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. Other duties, as assigned. Includes up to 75% local travel You ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Bachelor's Degree (or higher) 3+ years of healthcare industry experience 1+ year of experience working for a health plan and/or for a provider's office Microsoft Office specialist with exceptional analytical and data representation expertise; Advanced Excel, Outlook, and PowerPoint skills Ability to work a flexible 8-hour shift between the hours of 8:00am - 5:00pm Preferred Qualifications: 1+ years of STARs experience Medical/clinical background Knowledge of electronic medical record systems Consulting experience Knowledge of the Medicare market Knowledge base of clinical standards of care, preventive health, and Stars measures Experience in managed care working with network and provider relations/contracting Financial analytical background within Medicare Advantage plans (Risk Adjustment/STARS Calculation models) Soft Skills: Communication and presentation skills Relationship building skills with clinical and non-clinical personnel Problem-solving skills To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies required all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment. Careers with Optum . Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone of every race, gender, sexuality, age, location and income deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #RED

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