Assoc. Practice Performance Manager - Cleveland, OH

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM

Clinical

Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

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)

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.

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
  • Establish positive, long-term, consultative relationships with physicians, medical groups
  • 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 monthly 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


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:
  • 3+ years of healthcare industry experience
  • 1+ year of experience working for a health plan and/or for a provider's office
  • Proficiency in MS Outlook, Excel, and PowerPoint
  • Ability to travel (locally) up to 75%
  • Proven solid communication and presentation skills
  • Proven solid relationship building skills with clinical and non-clinical personnel
  • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance


Preferred Qualifications:
  • STARs experience
  • Consulting experience
  • Experience with EMR's
  • Medical/clinical background
  • Knowledge of the Medicare market
  • Knowledge base of clinical standards of care and preventive health
  • Experience in managed care working with network and provider relations/contracting
  • Financial analytical background within Medicare Advantage plans (Risk Adjustment/STARS Calculation models)


UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

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: Associate Practice Performance Manager, Travel, Cleveland, OH , Ohio

Advertisement

2028114