Associate Practice Performance Manager - Remote in Arkansas

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized.

About the Role

If you reside in Arkansas (Northwest Arkansas preferred), you will have the flexibility to work remotely* as you take on some tough challenges. This role involves up to 75% local travel.

Positions in this function drive clinical relationships and engagement with physician practices, members, and pharmacies while partnering internally (with areas such as Network contract ACO managers, Health Care Economics and Analytics, Medical Directors, Reporting, Health Plan market leaders) with a goal of improving health, well-being, quality, and practice performance while reducing medical costs. These roles are accountable for the full range of clinical practice performance, which may include but is not limited to:

• Improvement on HEDIS and STARs gap closure
• Coding accuracy
• Facilitating effective education and reporting
• Effective super utilizer engagement (e.g., members with complex and/or chronic conditions)
• Proactively identifying performance improvement opportunities through data analytics, technology, workflow changes, and clinical support

Responsibilities

• Program implementation and provider performance management tracked by designated provider metrics, including 4 STAR gap closure and coding accuracy
• Work directly with care providers to build relationships, ensure effective education and reporting, and proactively identify performance improvement opportunities
• Influence provider behavior to achieve needed results through analysis and discussion with subject matter experts
• 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 the health plan
• Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs, and ACOs
• Develop comprehensive, provider-specific plans to increase HEDIS performance and improve 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 for effective provider education, coaching, and consultation
• Coordinate and lead Stars-specific JOC meetings with provider groups 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 resources
• Facilitate/lead monthly or quarterly meetings, including report and material preparation
• Provide suggestions and feedback to Optum and the 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 in department campaigns to improve overall quality within measure star ratings or contracts
• Work internally with leadership on ad-hoc 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 gap closures
• Analyze and investigate, providing explanations and interpretations within your area of expertise

Requirements

• 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
• Microsoft Office specialist with exceptional analytical and data representation expertise; Advanced Excel, Outlook, and PowerPoint skills
• Proven solid communication and presentation skills
• Proven solid relationship-building skills with clinical and non-clinical personnel
• Driver's License and access to reliable transportation

Preferred Qualifications

• Consulting experience
• Experience in managed care working with network and provider relations/contracting
• Medical/clinical background
• 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
• Proven solid problem-solving skills
• Proven solid financial analytical background within Medicare Advantage plans (Risk Adjustment/STARS Calculation models)

Benefits

In addition to your salary, we offer:

• A comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements)

Pay

Pay is based on several factors including but not limited to local labor markets, education, work experience, and certifications. The salary for this role will range from $xx,xxx to $xx,xxx annually based on full-time employment.