UnitedHealth Group

Clinical Practice Performance Consultant - Greenville, AL and surrounding areas

UnitedHealth Group$72K — $130K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 5+ years in healthcare industry
  • 3+ years in health plan or provider office
  • 1+ year STARs experience
  • Managed care experience with network/provider relations
  • Knowledge of electronic medical records
  • Familiarity with Medicare market and clinical standards
  • Financial analytical skills related to Medicare Advantage plans
  • Microsoft Office proficiency, especially in advanced Excel, Outlook, and PowerPoint
  • Able to travel locally up to 75% of the time
  • Valid driver's license and reliable transportation

Responsibilities

  • Build relationships with care providers to ensure education and reporting
  • Travel across assigned territory to discuss UHG tools aimed at improving care quality
  • Execute provider incentive programs for health plan
  • Develop provider-specific plans to enhance HEDIS performance
  • Provide training and strategic recommendations on program implementation
  • Lead internal resources for effective provider education and consultation
  • Coordinate and lead Stars-specific meetings with provider groups for process improvement
  • Report on performance progress and gap closures to health plan leadership
  • Facilitate monthly or quarterly meetings with plan leaders
  • Collaborate with health plan market leads on initiatives for member empowerment
  • Participate in department campaigns to improve Star ratings
  • Work internally on projects to address performance in Star ratings
  • Create strategies to increase healthcare delivery and star ratings

Benefits

  • Comprehensive benefits package
  • Incentive and recognition programs
  • Equity stock purchase options
  • 401k contributions
  • Development opportunities for career advancement
Full Job Description
The 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.

For consideration, you must reside within a commutable distance of Greenville, AL and Southeast AL Markets as this is a field based role

Primary Responsibilities:

  • 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
  • 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:

  • 5+ years of healthcare industry experience
  • 3+ years of experience working for a health plan and/or for a provider's office
  • 1+ years of STARs experience
  • Experience in managed care working with network and provider relations/contracting
  • 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 (Risk Adjustment/STARS Calculation models)
  • Microsoft Office specialist with exceptional analytical and data representation expertise; Advanced Excel, Outlook, and PowerPoint skills
  • Must be able to travel within local territory up to 75%
  • Driver's License and access to a reliable transportation


Preferred Qualifications:

  • Bachelor's Degree or equivalent work experience
  • Medical/clinical background
  • Consulting experience
  • Consulting experience
  • Proven solid problem-solving skills
  • Proven solid communication and presentation skills
  • Proven solid relationship building skills with clinical and non-clinical personnel


Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. 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. The salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

About UnitedHealth Group

UnitedHealth Group is a medical facility. They offer health technology, health finance, and pharmacy services. They are utilizing clinical data and intelligence to assist in the redesign, automation, and deployment of technology to streamline administrative operations and clinical decision-making. Payment systems for both consumers and providers are critical components of a health-care system.

UnitedHealth Group Careers

Joining UnitedHealth Group means becoming part of a diverse team dedicated to making a difference. As a leader in health services and innovation, our company offers a variety of job opportunities that allow professionals to leverage their skills, drive innovation, and improve lives. Work You’ll Do At UnitedHealth Group, you’ll contribute to a mission-focused environment where your expertise will influence the health and well-being of people worldwide. Our employment opportunities span across a wide range of disciplines, from healthcare specialists to data analysts, ensuring that your career journey is both dynamic and rewarding. Transform Healthcare with Your Expertise UnitedHealth Group stands at the forefront of health innovation. Our team collaborates to deliver solutions that lead to better patient outcomes. Working with us, you’ll find yourself at the intersection of technology, healthcare, and leadership, providing key insights that drive industry transformation. Join Our Global Team As part of our team, you’ll engage with over 300,000 professionals globally, dedicated to building a diverse and inclusive workplace. UnitedHealth Group is not just a company; it’s a community where you can grow your career through continuous learning and leadership opportunities. Our commitment to diversity training ensures that every team member can thrive. UnitedHealth Group Career Development We are committed to your professional growth. Explore career paths filled with promising job opportunities and internships that will harness your potential and expand your capabilities. Whether you’re a seasoned professional or a recent graduate, you’ll find that our career development programs support your ambition at every level. Innovative Work Environment At UnitedHealth Group, innovation is at the core of our operations. We encourage our team to bring forward-thinking ideas that challenge the status quo and lead to breakthrough improvements in patient care. Be Part of a Great Team Our culture fosters a collaborative and supportive environment where every member’s contribution is valued. Enjoy the benefits of being part of a global team that’s committed to making a difference in people’s lives. Future-Proof Your Career With UnitedHealth Group, your career is future-proof. Dive into a range of positions that offer both challenges and rewards. Our robust support system includes unmatched training, development programs, and certification support to propel your career forward. Stay Connected Join Our Team Discover the right position that matches your skills and interests. We are always hiring and look for passionate, curious, and solution-driven team players. Search UnitedHealth Group jobs today and take the first step towards a fulfilling career. Keep Up to Date Stay informed with career tips, insider perspectives, and industry-leading insights you can use today—all from the people who work here. Read Careers Blog Job Alert Emails Customize your subscription to receive job alerts, the latest news, and insider tips tailored to your preferences. Explore the exciting and rewarding opportunities that await at UnitedHealth Group.
Learn more about UnitedHealth Group
Size
350,000 employees
Market Cap
$493.1 billion
Industry
Net Income
$15.4 billion
Founded
1974
5 Year Trend
+9.2%
Revenue
$257.1 billion
NASDAQ

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