Associate Practice Performance Manager - Field Position In Sc

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 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)

NOTE: Qualified candidates must live in the Charleston SC / Hilton Head SC Regional Area to be eligible for consideration (routine travel is required in this region)

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. 

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.

Years of post-high school education can be substituted/is equivalent to years of experience

Required Qualifications:

• 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 (specifically Advanced Excel, Outlook, and PowerPoint skills required)
• Must live in the Charleston SC / Hilton Head SC regional area to be considered (routine travel is required in this area)
• Must be able/willing to travel approximately 75% in the Charleston SC / Hilton Head SC regional area (qualified candidates must reside in this area to be considered)
• Must be able to provide proof of a valid Driver's License and current Auto Insurance

Preferred Qualifications:

• 1 year of STARs experience 
• Experience in managed care working with network and provider relations/contracting
• Consulting experience
• Proven solid financial analytical background within Medicare Advantage plans (Risk Adjustment/STARS Calculation models)
• Medical/clinical background
• Solid knowledge of electronic medical record systems
• Solid knowledge of the Medicare market
• Knowledge base of clinical standards of care, preventive health, and Stars measures
• Proven solid communication and presentation skills
• Proven solid relationship building skills with clinical and non-clinical personnel
• Proven solid problem-solving skills

California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $56,300 to $110,400 per year. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. 

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy 

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 employers 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