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Associate Practice Performance Manager - Seattle, WA

Company: UnitedHealth Group
Location: EDMONDS
Posted on: May 3, 2021

Job Description:

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.

Primary Responsibilities:

  • Make outbound calls and receive inbound calls to assess members' current health status

  • 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.

Daily Practices:

  • Strong communication and presentation skills

  • Strong relationship building skills with clinical and non-clinical personnel

  • Strong problem-solving skills

Youll 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:

  • Bachelors Degree required or 5 years experience within the healthcare industry

  • 3+ years of healthcare industry experience

  • 1+ year of experience working for a health plan and/or for a provider's office

  • Includes up to 75% local travel

  • Microsoft Office specialist with exceptional analytical and data representation expertise; Advanced Excel, Outlook, and PowerPoint skills required

  • You will be asked to perform this role in an office setting or other company location.

  • Employees are required to screen for symptoms using theProtectWellmobileapp, Interactive Voice Response (i.e., entering your symptoms via phonesystem)or a similar UnitedHealth Group-approved symptom screener prior toentering the work site each day, in order to keep our work sites safe.Employees must comply with any state and local masking orders.In addition, when in a UnitedHealth Group building, employees are expectedto wear a mask in areas where physical distancing cannot be attained.

Preferred Qualifications:

  • 1+ year of STARs experience

  • Medical/clinical background

  • Strong knowledge of electronic medical record systems

  • Consulting experience

  • Strong knowledge of the Medicare market

  • Knowledge base of clinical standards of care, preventive health, and Stars measures

  • Experience in managed care working with network and provider relations/contracting

  • Strong financial analytical background within Medicare Advantage plans (Risk Adjustment/STARS Calculation models)

UnitedHealth Group is an essential business.The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us.

You can learn more about all we are doing to fight COVID-19 and support impacted communities:.

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.

Keywords: performance manager, provider, provider management, care provider, relationship building, Seattle, WA, Washington, hiring immediately, #RPO

Keywords: UnitedHealth Group, Edmonds , Associate Practice Performance Manager - Seattle, WA, Other , EDMONDS, Washington

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