If you are located within Central Pennsylvania, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges.
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 Healthcare 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
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)
This position is full – time. Employees are required to work our normal business hours of 8:00 AM – 5:00 PM. It may be necessary, given the business need, to work occasional overtime or weekends.
We offer 4 weeks of training. Training will be conducted virtually from your home.
All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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
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.
High School Diploma / GED (or higher) OR equivalent experience
3+ years of healthcare industry experience
Microsoft Office specialist with exceptional analytical and data representation expertise: Advanced skills in Microsoft Excel, Microsoft Outlook, and Microsoft PowerPoint
Medical / clinical background
Ability to work in the office as based on business need
Ability to travel up to 75% of the time (Domestic) in the role
Ability to work any 8-hour shift between the hours of 8:00 AM – 5:00 PM
Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
1+ years of experience with working for a health plan and / OR for a provider’s office
1+ years of STARs experience
Current PA RN license
Knowledge of electronic medical record systems
Knowledge of the Medicare market
Knowledge base of clinical standards of care, preventive health, and Stars measures
Experience in managed care and working with network and provider relations / contracting
Financial analytical background within Medicare Advantage plans (Risk Adjustment / STARS Calculation models)
Reside within Central Pennsylvania
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
Strong communication and presentation skills
Strong relationship building skills with clinical and non-clinical personnel
Strong problem – solving skills
UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.
Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military
Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet
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
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.
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