The Senior Clinical Transformation Consultant (Senior CTC) is responsible for the ongoing clinical management of physician practices participating in UnitedHealthcare's (UHC) Accountable Care Organizations (ACO), Value Based Programs, Patient Centered Medical Homes (PCMH), or Population Health Management programs such as Patient Centered Care Model. The Senior CTC will lead multi-disciplined practice transformation and practice performance improvement initiatives. The selected candidate will guide practices in achieving targeted goals that include improved quality, efficiency and utilization. The Senior CTC is accountable for driving practice progress toward desired transformational change and performance improvement, while meeting savings goals set for the practice.
The Senior CTC reports directly to the Regional Director. The Senior CTC will act as a mentor to other Transformation Consultants on the team. As the single clinical point of contact for a practice, the Senior CTC will be responsible for communicating progress towards achievement of targeted goals to Senior Leadership both within UnitedHealthcare and at the practice.
If you are located within a commutable distance of St. Louis and Springfield, MO area, you will have the flexibility to work remotely* as you take on some tough challenges.Primary Responsibilities:- Successful deployment of UHC's Clinical Support program at the practice level, including but not limited to, introducing and educating practices on the value/use of reporting tools, patient registries and delivery of reports via UHC's Physician Portal
- Build and effectively maintain relationship with the practice leadership and key clinical influencers actively involved in practice transformation
- Regularly facilitate efficient, effective practice improvement meetings with the practice to monitor, present, and discuss progress on the transformation action plan and achievement in milestones
- Develop strategies; based on performance analysis, for improvement that includes specific outcomes and metrics to monitor progress to a goal and make recommendations for improvement
- Design practice transformation action plans and implement appropriate performance improvement initiatives designed to assist the practice in achieving contractually required transformation milestones
- Monitor and review the progress of the practice in milestone achievement and insure the practice is accountable for successful completion
- Use data to analyze key cost, utilization and quality data and interpret results to assess the performance of the practice
- Use data to analyze trends and work with stakeholders to agree on and implement proactive strategies to address issues, and measure impact using a PDSA rapid cycle improvement approach; including external practice data
- Assist practices in creating work flows to optimize care delivery, introduce best practices improvements, and evaluate outcomes using rapid cycle improvements PDSA methods to reach mutual goals
- Educate & Deploy technology tools to support Practice Transformation
- Integrate technology tools into practice workflows
- Build and effectively maintain relationships with team members in the UHC Clinical organization as well Medical Directors, local Network leads, Health Care Economic Analysts and Clinical Analysts in support of the program
- Consult and partners with internal UHC matrix partners and the practice to identify organizational and structural challenges hindering achievement of desired program outcomes
- Collaborate with UnitedHealthcare teams including the practice Care Coordinators, quality management teams, hospital clinical teams, behavioral health teams to support integrated PCP driven care for our members with practices and hospitals
- Consult and guide the practice on developing innovative solutions, including bringing best practice experience and connecting practices with other high performing practices to spur innovation
- Work with the practice and Optum to align and integrate Optum care/disease management programs and population health services to augment the practice's capabilities, support their care management efforts and add value to the patient care experience
- Assist and support department leaders in summarizing and disseminating experience - related learning's by way of team updates, written reports / articles, and / or presentations as called for by directors
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 9+ years of experience with improving clinical quality, health care analytics, or driving clinical transformation initiatives with population health programs, Patient Center MedicalHomes or in Accountable Care Organizations
- 5+ years of combined experience with improving clinical quality, health care analytics, or driving clinical transformation initiatives with population health programs, Patient Center MedicalHomes or in Accountable Care Organizations
- 2+ years of experience interpreting and utilizing clinical data analytics, outcomes measurement in healthcare and use of that data to drive change
- Experience working with and collaborating successfully with senior level leadership
- Demonstrated experience leading groups and solid presentation skills
- Solid Microsoft Office Skills with Word, Excel (Intermediate +), Outlook and PowerPoint
- Demonstrated solid relationship building skills with internal and practice teams to drive goal alignment
- Access to high speed internet for home office set up
- Willingness to travel between 10-15% for face to face meetings
- Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area (markets may require valid driver's license)
Preferred Qualifications:- Master's Degree
- Active, unrestricted RN or LPN licensure in the State of Residence
- Medicare Advantage experience
- Medicaid experience
- Commercial experience
- Population health management experience within an ambulatory setting
- Physician practice experience
- Sales experience (Business to Business or Business to Consumer)
- Demonstrated experience implementing Clinical Practice Transformation initiatives designed to help provider or hospital groups achieve large-scale health transformation goals
- Experience preparing and presenting information to clinical and executive level leadership
- Knowledge and/or experience with HEDIS measures
- Knowledge and/or experience with risk adjustments
- Knowledge and/or experience with STARS
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
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 $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.
