Associate Practice Performance Manager - Field Position (New Orleans, LA)

UnitedHealth Group•New Orleans, LA

17d•Remote

About The Position

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? 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. If you are located in New Orleans, LA you will have the flexibility to work remotely as you take on some tough challenges.

Requirements

3+ years of healthcare industry experience
1+ year of experience working for a health plan and/or for a provider's office
1+ year of HEDIS STARs experience
Demonstrated intermediate or higher level of proficiency using Microsoft Office, specifically Word, Excel, Outlook, and PowerPoint
Reside in the New Orleans LA regional area (routine travel is required in this area)
Able/willing to travel approximately 75%25 in the New Orleans LA regional area (must live in this region to perform daily travel requirements)
Proof of a valid Driver’s License, access to reliable transportation and current auto insurance

Nice To Haves

Medical/clinical background
Proven solid knowledge of electronic medical record systems
Consulting experience
Proven solid knowledge of the Medicare market
Demonstrated knowledge base of clinical standards of care, preventive health, and Stars measures
Experience in managed care working with network and provider relations/contracting
Proven solid problem-solving skills
Demonstrated solid financial analytical background within Medicare Advantage plans (STARS Calculation models)

Responsibilities

Functioning independently, travel across assigned territory to meet with providers to discuss UHC 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
May conduct telephonic member needs assessments according to state and national guidelines, policies, procedures, and protocols
May interact with members via telephone; Schedule appointments, Follow-up calls to assess understanding of services, answer questions and ascertain that additional procedures have been completed that relate to preventative health screenings or HEDIS gaps in care
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 UHC 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 UHC 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
Solid communication and presentation skills
Solid relationship building skills with clinical and non-clinical personnel
Other duties, as assigned

Benefits

In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives.

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