There comes a point when you're ready to take off the training wheels and start guiding others. If that's where you are today, let's talk about where you can be tomorrow with our leading, global health care organization. UnitedHealth Group is driving ever higher levels of sophistication in how provider networks are composed and compensated. Everything is open to new ideas and innovation. Here's where you come in. Your expertise in provider networks can help us build in the next phase of evolution. In this role, you'll use your knowledge and analytical skills to help determine how clinical providers group up by specialty and service line. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 5 leader.
The Healthcare Advocate, Market Consultant is responsible for the full range of provider relations services within UnitedHealth Group.
If you are located in Dallas/Fort Worth TX, you will have the flexibility to telecommute* as you take on some tough challenges.
- Function independently, meeting with physicians to discuss Optum tools and programs focused on improving the quality of care for Medicare & Medicaid Advantage Members.
- Utilize data analysis, identify and target providers who would benefit from our Medicare/Medicaid Risk Adjustment & HEDIS/STARS training and documentation/coding resources
- Educate providers on how to improve their Risk Adjustment Factor (RAF) scores and HEDIS/STARS performance
- Reach out to physicians, medical groups, IPAs, and PHO’s, to build positive, long-term, consultative relationships
- Develop comprehensive, provider-specific plans to improve performance
- Train providers on our programs and tools, and work toward the adoption of these programs in to their practices
- Collaborate with doctors, coders, facility staff and a variety of internal and external personnel on a wide scope of Risk Adjustment education efforts
- Undergraduate degree required; advanced degree a plus
- 3+ years of experience working in the health insurance or health services industries
- 3+ years of provider network management, physician contracting, healthcare consulting, Medicare Advantage sales or Pharmaceutical sales experience
- Knowledge of Managed Care and Medicare programs; prior experience with commercial and Medicare regulations is strongly preferred
- Intermediate (or better) level of proficiency in MS Office Suite; prefer strong MS Excel skills
- Ability to travel up to 75% regionally within the designated market area and possible monthly travel outside their designated market
- Knowledge of ICD10, Risk Adjustment, HEDIS and Stars
- Excellent written and oral communication skills with internal and external business partners and employees
- Strong business acumen and analytical skills
- Exceptional presentation skills; experience giving group presentations is preferred.
- Ability to develop long term relationships
- Strong influencing and negotiation skills
- Results-orientation; must be self-motivated and goal oriented and able to work under ambiguity; good work ethic & desire to succeed Strong process and project management skills
- Ability to work independently and remain on task; ability to prioritize and meet deadlines
- Good organization and planning skills
Careers 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
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy
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: Risk Adjustment, HEDIS, STARS consultations, consultant, coding, quality, telecommute, telecommuter, telecommuting, work from home, WFH