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. 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. Primary Responsibilities: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 membersExecute applicable provider incentive programs for health planEstablish positive, long-term, consultative relationships with physicians, medical groups, IPAs and ACOsDevelop comprehensive, provider-specific plans to increase their HEDIS performance and improve their outcomesProvide ongoing strategic recommendations, training and coaching to provider groups on program implementation and barrier resolutionAct 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 systemsCoordinate 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, HQPAFs, gap closure, and use of virtual administrative resourceFacilitate/lead monthly or quarterly meetings, as required by plan leader, including report and material preparationProvide 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
Required Qualifications:Bachelor's Degree required or equivalent work experience 1+ year of STARs experience 5+ years of healthcare industry experience3+ years of experience working for a health plan and/or for a provider's officeMust have access to reliable transportation and be able to travel locally up to 75% At least an intermediate proficiency with Microsoft Office suite (especially Excel, Outlook and PowerPoint)Preferred Qualifications: Clinical experienceConsulting experience Experience in managed care working with network and provider relations/contractingKnowledge of the Medicare marketKnowledge base of clinical standards of care, preventive health, and STARs measuresKnowledge of electronic medical record systemsFinancial analytical background within Medicare Advantage plans (Risk Adjustment / STARS Calculation models)Strong problem-solving, communication, relationship building and presentation skillsCareers 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) 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: healthcare, health care, STARs, provider, performance measures, reporting, Medicare, Medicare Advantage, HEDIS, Chicago, Naperville, Joliet, IL, Illinois
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.