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Careers at UnitedHealth Group

 

We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Medical and Clinical Operations

Country:

United States

Postal Code:

12901

Approximate Salary:

Not Specified

Position Type:

Full Time

Quality Practice Performance Coordinator - Plattsburgh, NY

UHG - Plattsburgh, New York

Posted: 09/2/2018

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)   The Practice Performance Coordinator 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. The person will also collect charts (paper and electronic - EMR), look for gaps in care, perform member telephonic outreaches to help coordinate doctor appointments, schedule screenings, make follow-up calls to members after appointments, and assist our members in overall wellness and prevention addressing compliance in medication adherence and control measures.   If you are located in Plattsburgh, NY, you will have the flexibility to telecommute* as you take on some tough challenges. This role will be based out of the employee's home but will be required to travel throughout the state of NY to various provider offices.   Primary Responsibilities:

  • Functioning independently, responsible to engage Providers to discuss UHC tools and programs focused on improving the quality of care for Medicare Advantage Members with a specific focus on HEDIS measure gap closure
  • Provide ongoing strategic recommendations, training and coaching to provider groups on program implementation and barrier resolution
  • Assist members in navigating their network of providers by assisting with follow-up and specialist appointments as needed
  • Assist members with program eligibility and appropriate referrals to remove barriers in care. This may include referrals to case management and/or social worker services
  • Interaction with UHC members via telephone to assist and support an appropriate level of care. This may include making outbound calls to members and/or providers to assist in scheduling appointments, closing gaps in care or chart collection activities
  • Answer inbound calls from patients and/or providers regarding appointments
  • 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 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 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 

Required Qualifications:
  • Bachelor’s Degree required or equivalent work experience
  • 1+ years of healthcare industry experience
  • 1+ year of experience working for a health plan and/or for a provider's office
  • 1+ year of customer/patient outreach experience
  • Strong communication and presentation skills
  • Strong relationship building skills with clinical and non-clinical personnel
  • Microsoft Office specialist with exceptional analytical and data representation expertise; Advanced Excel, Outlook, and PowerPoint skills
  • Willingness and ability to travel to providers throughout Rhode Island
  Preferred Qualifications:
  • Medical/clinical/pharmaceutical background highly preferred
  • Consulting experience highly preferred
  • Strong knowledge of the Medicare market
  • Knowledge base of clinical standards of care, preventive health, and Stars measures
  • Experience in managed care working with network and provider relations/contracting
  • Strong problem-solving skills
  • Strong financial analytical background within Medicare Advantage plans (Risk Adjustment/STARS Calculation models)
  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 worlds 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: Quality, Practice Performance, Coordinator, Plattsburgh, NY, New York, Telecommute

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