Opportunities with Optum in the Tri-State region (formerly CareMount Medical, ProHEALTH New York and Riverside Medical Group). Come make a difference in the lives of people who turn to us for care at one of our hundreds of locations across New York, New Jersey and Connecticut. Work with state-of-the-art technology and brilliant co-workers who share your passion for helping people feel their best. Join a dynamic health care organization and discover the meaning behind Caring. Connecting. Growing together.
This role will oversee Practice Performance Managers (PPM) to support their achievement of established performance goals. This role will also have subset of assigned practices in addition to the management responsibility of PPMs. This role is also responsible for provider performance management for their aligned membership 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 the Director of IPA, care providers to build relationships, ensure effective education and reporting, and to proactively identify performance improvement opportunities through analysis and discussion with subject matter experts.
If you live within either NY or NJ, you will have the flexibility to work remotely* as you take on some tough challenges.

REQUIRED QUALIFICATIONS:

• 5+ years of healthcare industry experience (Provider Office Operations, STARs Quality Improvement, HCC Coding Education, Provider Engagement/Liaison)
• 2+ years of STARs experience
• Solid communication and presentation skills
• Solid relationship building skills with clinical and non-clinical personnel; experience with establishing trusted relationships with providers and collaborating effectively with team members
• Solid analytical and problem solving skills; comfortable using data to pinpoint opportunity area, developing a cohesive strategy and implementing solutions to achieve performance goals
• Driver’s License and access to reliable transportation

PREFERRED QUALIFICATIONS:

• Certified Professional Coder (CPC) and/or Certified Risk Adjustment Coder (CRC)
• 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
• Solid problem-solving skills
• Solid financial analytical background within Medicare Advantage plans (Risk Adjustment/STARS Calculation models)
• Microsoft Office specialist with exceptional analytical and data representation expertise; Advanced Excel, Outlook, and PowerPoint skills
• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
  Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.
  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.
  UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
  UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment

• People Management Responsibilities:
• Strategically manage and expand three new market initiatives in close collaboration with Director
• Cultivate new relationships and facilitate the successful onboarding of new practices within desiginated markets
• Manage team of 3-5 PPM resources to performance goals: 4 STAR gap closure and 90% of HCC covered
• Support onboarding and ongoing coaching of PPM direct reports
• Support PPMs with onboarding of new practices to programs and establishment of attestation and quality gap closure workflows
• Ensure direct reports have regularly scheduled meetings (monthly) with assigned practices/physicians
• Partner with direct reports to support removal of barriers to engagement with practices prior to further leadership escalation
• Lead sharing of best practices and use of standardized materials/education across PPM direct reports
• Complete quarterly check-ins with each PPM direct report
• Support assignment/reassignment of practices to PPMs based on geography, total estimated membership, level of engagement, etc.
• Manage a solid team through effective training, coaching, discipline, team building and succession planning to achieve a high level of staff satisfaction and performance
• Reinforce education provided to direct reports through review of workflows
• Participate within department campaigns to improve overall quality improvements within measure star ratings or contracts
• Work internally with leadership on adhoc projects, initiatives, and sprints to address measure star ratings and increase overall measure performance
• Actively report challenges and barriers to practice performance with Director of IPA Performance and collaborate on solutions
• Proactively work on action plans for targeted provider groups to increase healthcare delivery, star ratings, and maximize on gap closures
  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