Field Based Associate Practice Performance Manager - Palm Beach OR BrowardCounty, FL

Company: UnitedHealth Group
Location: Boca Raton
Posted on: March 10, 2023

Job Description:

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. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Field Based 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).

This position is full - time (40 hours / week), Monday - Friday. Employees are required to work any 8-hour shift between the hours of 8:00 AM - 5:00 PM. Training will be conducted virtually from your home.

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
--- Weekly commitment of 60% travel for business meetings (including client / health plan partners and provider meetings) and 40% remote work

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) OR equivalent work experience
--- 3+ years of healthcare industry experience
--- 1+ years of experience with working for a health plan and / OR for a provider's office
--- Microsoft Office specialist with exceptional analytical and data representation expertise, including Advanced skills in using Microsoft Excel (ability to create, edit, modify, and sort spreadsheets and pivot tables, leverage advanced analytical formulas [lookup, match, if], apply nested formulas), Microsoft Outlook (email and calendar management), Microsoft PowerPoint (ability to create and edit slides)
--- Ability to travel up to 60% of the time (Domestic)
--- Reside within Palm Beach OR Broward County, FL
--- Required to have a dedicated work area established that is separated from other living areas and provides information privacy
--- Ability to keep all company sensitive documents secure (if applicable)
--- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
--- Ability to work any 8-hour shift (40 hours / week) between the hours of 8:00 AM - 5:00 PM from Monday - Friday

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:

--- Strong relationship building skills with clinical and non - clinical personnel
--- Strong communication and presentation skills
--- Strong problem - solving skills

Careers with OptumInsight. Information and technology have amazing power to transform the Healthcare industry and improve people's lives. This is where it's happening. This is where you'll help solve the problems that have never been solved. We're freeing information so it can be used safely and securely wherever it's needed. We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life's best work.SM

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

Keywords: UnitedHealth Group, Boca Raton , Field Based Associate Practice Performance Manager - Palm Beach OR BrowardCounty, FL, Executive , Boca Raton, Florida