Associate Practice Performance Manager - Remote

UnitedHealth Group•Shreveport, LA

9d•Remote

About The Position

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? 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. NOTE: Qualified candidates must live in the Shreveport LA Regional Area to be eligible for consideration (routine travel is required in this region) If you live in the Shreveport LA regional area to perform daily travel requirements, you will have the flexibility to work remotely as you take on some tough challenges.

Requirements

3+ years of healthcare industry experience
1+ years of experience working for a health plan and/or for a provider's office
1+ years of HEDIS STARs experience
Intermediate or higher level of proficiency using Microsoft Office, specifically Word, Excel, Outlook, and PowerPoint
Live in the Shreveport LA regional area to be considered (routine travel is required in this area)
Able/willing to travel approximately 75%25 in the Shreveport LA regional area (qualified candidates must reside in this area to be considered)
Ability to provide proof of a valid Driver’s License and current Auto Insurance

Nice To Haves

Experience in managed care working with network and provider relations/contracting
Consulting experience
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
Solid financial analytical background within Medicare Advantage plans (STARS Calculation models)
Proven solid problem-solving skills

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