Practice Performance Manager - Telecommute in Rochester or Buffalo, NY

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 is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

This role is responsible for 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, and to proactively identify performance improvement opportunities through analysis and discussion with subject matter experts. 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)

If you are located in Rochester or Buffalo, NY area, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:
  • Program implementation and provider performance management which is tracked by designated provider metrics, inclusive minimally of 4 STAR gap closure and coding accuracy
  • 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
  • Functioning independently, travel across assigned territory to meet with providers to discuss UHG tools and programs focused on improving the quality of care for Medicare Advantage Members
  • Execute applicable provider incentive programs for health plan
  • 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
  • Participate within department campaigns to improve overall quality improvements within measure star ratings or contracts
  • Work internally with leadership on adhoc projects, initiatives, and sprints to address measure star ratings and increase overall measure performance
  • Create strategy and action plans for targeted provider groups to increase healthcare delivery, star ratings, and maximize on gap closures
  • 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.

Required Qualifications:
  • Bachelor's Degree or equivalent work experience
  • 5+ years of healthcare industry experience
  • 3+ years of experience working for a health plan and/or for a provider's office
  • 1+ year of STARs experience
  • 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:
  • Consulting experience
  • Experience in managed care working with network and provider relations/contracting
  • Experience with financial analysis within Medicare Advantage plans (Risk Adjustment/STARS Calculation models)
  • Medical/clinical background
  • Knowledge of electronic medical record systems
  • Knowledge of the Medicare market
  • Knowledge base of clinical standards of care, preventive health, and Stars measures
  • Microsoft Office specialist with exceptional analytical and data representation expertise; Advanced Excel, Outlook, and PowerPoint skills

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

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)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

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: Practice Performance Manager, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, Rochester, Buffalo, NY, New York

Advertisement

2023108