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Job Information

UnitedHealth Group Practice Performance Manager - Field based in Missouri in Springfield, Missouri

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

This role is responsible for 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, and to proactively identify performance improvement opportunities through analysis and discussion with subject matter experts.

This role is home-based but will require travel throughout the state of Missouri at least 75% of the time.

Primary Responsibilities:

  • The 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

  • 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. Training will include Stars measures (HEDIS/CAHPS/HOS/med adherence), and Optum program administration, use of plan tools, reports and systems

  • 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

  • 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 required or equivalent work experience

  • 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 experience implementing process improvement and/or quality measures

  • Excellent communication and presentation skills

  • Strong relationship building skills with clinical and non-clinical personnel

  • Available to travel to provider offices 75% of the time

  • Dedicated space in home for home office

  • Access to high speed internet (DSL or Cable)

  • You will be asked to perform this role in an office setting or other company location, however, may be required to work from home temporarily due to space limitations

  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained

Preferred Qualifications:

  • Medical/clinical background

  • HEDIS/STARs experience

  • Strong knowledge of electronic medical record systems

  • Consulting experience

  • Strong 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

  • Strong problem-solving skills

  • Strong financial analytical background within Medicare Advantage plans (Risk Adjustment/STARS Calculation models)

  • Microsoft Office specialist with exceptional analytical and data representation expertise; Advanced Excel, Outlook, and PowerPoint skills

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

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.

Job Keywords: Quality, Practice, Performance, Manager, quality measures, HEDIS, STARS, Medicare, provider,Missouri, MO, Springfield Telecommute, travel

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