[Hiring] Senior Provider Engagement Specialist @UnitedHealth Group

Role Description

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 to start Caring. Connecting. Growing together.

This position functions as a subject matter expert in Client Service operations. This position strives to bring consistency and experience to existing Provider Engagement Specialists in the local market by analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning. This position will organize and assist assigned provider groups and/or financial pools, as well as fellow account managers, in achieving short and long term operational/strategic business goals by developing, enhancing and maintaining operational information and models. They also develop and implement, in conjunction with the local Client Services Associate Director and/or Director, effective/strategic business solutions through research and analysis of data and business processes. The Senior Provider Engagement Specialist will develop and sustain a solid day-to-day relationship with stakeholders, the providers, and office staff to effectively implement business solutions developed by the Optum leadership team. The Senior Provider Engagement Specialist is accountable for overall performance and profitability for their assigned provider groups and/or financial pools.

Essential Job Functions

• Analyze risk pool and/or provider group performance to determine areas of focus or improvement opportunities.
• Develop strategies and create action plans that align provider pools and groups with company initiatives, goals (revenue and expense) and quality outcomes.
• Drive processes and improvement initiatives that directly impact revenue, HEDIS/STAR measures and quality metrics, coding and documentation process and educational improvements.
• Use and analyze data to identify trends, patterns and opportunities for the business and clients.
• Collaborate with internal clinical services teams, alongside Client Services leaders, to monitor utilization trends and risk pools.
• Assist provider groups with investigating standard and non-standard requests and problems.
• Maintain effective support services by working effectively with the Director of Client Services, Regional Medical Director, Clinical Services team, Operations and other corporate departments.
• Demonstrate understanding of providers' business goals and strategies in order to facilitate the analysis and resolution of their issues.
• Perform all other related duties as assigned.

If you are located in Charlotte, NC you will have the flexibility to work remotely as you take on some tough challenges.

Primary Responsibilities

• Data analysis required to support, compile and report key information.
• Drive processes and technology improvement initiatives that directly impact Revenue, HEDIS/STAR measures and Quality Metrics.
• Use data to identify trends, patterns and opportunities for the business and clients.
• Engage provider staff and providers in analysis and evaluation of functional models and process improvements.
• Evaluate and drive processes, provider relationships and implementation plans.
• Produce, publish and distribute scheduled and ad-hoc client and operational reports.
• Collaborate with other Client Services leads to foster teamwork and build consistency throughout the market.
• Serve as a liaison to the health plan and all customers.
• Requires solid presentation skills, problem solving and ability to manage conflict and identify resolutions quickly.
• Have the ability to communicate well with physicians, staff and internal departments.

Qualifications

• 5+ years of experience in a related medical field or health plan setting (network management, contracting and/or recruitment, provider relations or in medical practice).
• Experience with Medicare health care operations including HEDIS, CMS reimbursement models, and Medicare Advantage.
• Experience developing long-term positive working relationships.
• Experience communicating and facilitating strategic meetings with groups of all sizes.
• Experience working independently, using good judgment and decision-making.
• Experience conducting performance evaluations to identify performance measures or indicators.
• Experience resolving complete problems and evaluating options to implement solutions.
• Knowledge of state and federal laws relating to Medicare.
• Proficiency in Microsoft Word, Excel and PowerPoint.
• Reliable transportation and ability and willingness to travel, both locally in assigned territory and non-locally, as determined by business need up to 70%.
• Permanent residence within a commutable distance to Charlotte, NC.

Preferred Qualifications

• 3+ years of healthcare management experience.
• Experience acting as a mentor to others.
• Client Management experience.

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

Company Description

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.

OptumCare 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.