Field Based Provider Performance Consultant

4 weeks ago

Palm Springs, California, United States UnitedHealth Group US Full time

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Optum's Pacific West region is redefining health care with a focus on health equity, affordability, quality, and convenience. From California to Oregon and Washington, we are focused on helping more than 2.5 million patients live healthier lives and helping the health system work better for everyone. At Optum Pacific West, we care. We care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions.

Positions in this function drive clinical relationships and engagement with physician practices, members, while partnering internally (with areas such as Network contract mgrs., Analytics, Medical Directors, Supportive Care Programs, and Health Plan market leaders) with a goal of improving practice performance. Positions are accountable for e a range of clinical practice performance initiatives, which may include, but is not limited to improvement on chronic condition documentation, HEDIS, and STARs gap closure. This position will also support network offices through effective education and reporting of metrics, accessing support programs available for management of members with complex and/or chronic conditions, and proactively identifying performance improvement opportunities through the use of data analytics, technology, workflow changes and clinical support. These roles develop comprehensive, provider-specific plans to increase their physician practice performance, reduce readmissions and improve their outcomes.

This position is full time (40 hours/week) Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:30am – 5:00pm PST. It may be necessary, given the business need, to work occasional overtime or weekends.

We offer 2 weeks of paid training. The hours during training will be 8:00am to 5:00pm, Monday – Friday.

Primary Responsibilities:

  • Advance high volume office workflow and programmatic coordination in collaboration with the PRMs
  • Complete in office assessment and advise on the development of supportive action plans
  • Maintain the office action plan (in partnership with other accountable teammates and stakeholders)
  • Host regular meetings / engagement cadence with office in collab with IPA staff
  • Training / System Support / Education
  • Coordinate with accountable teams for at the elbow training and system support (Practice Connect, Cozeva)
  • Liaises on system challenges (Practice Connect, Cozeva, etc.) and escalates challenges to Optum resources – at the elbow
  • Coordinate training and education sessions with Medical Directors to complete
  • Clinical Support
  • Chart dives to support quality and risk documentation
  • Enter supplemental data on behalf of the office
  • Determine event planning, coordination, and management for health fairs to support regional advancement of goals
  • Support incomplete / amend / lookback workflows for high volume offices
  • PRM Collaboration: Support PRMs in questions on pursuit list generation and reinforce PRM messages in the IPA office

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:

  • High School Diploma / GED
  • Must be 18 years of age OR older
  • Healthcare setting experience
  • Ability to travel up to 75% of the time
  • Ability to use computer and multi-systems
  • Ability to work any of our 8-hour shift schedules during our normal business hours of 7:30am – 5:00pm PST. It may be necessary, given the business need, to work occasional overtime or weekends

Preferred Qualifications:

  • Quality Performance or Quality Risk Adjustment experience
  • Bilingual fluency in Spanish

California Residents Only: The hourly range for this is $19.47 – $38.08 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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.

#RPO #RED

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