Associate Practice Manager - Field Position; Orleans, LA

Overview

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives?

Join us to start Caring. Connecting. Growing together.

• Functioning independently, travel across assigned territory to meet with providers to discuss UHC tools and programs focused on improving the quality of care for Medicare Advantage Members
• Execute applicable provider incentive programs for health plan
• Assist in the review of medical records to highlight Star opportunities for the medical staff
• May conduct telephonic member needs assessments according to state and national guidelines, policies, procedures, and protocols
• May interact with members via telephone;
  Schedule appointments, follow-up calls to assess understanding of services, answer questions and ascertain that additional procedures have been completed that relate to preventative health screenings or HEDIS gaps in care
• Activities include data collection, data entry, quality monitoring, upload of images, and chart collection activities
• Locate medical screening results/documentation to ensure quality measures are followed in the closure of gaps. Will not conduct any evaluation or interpretation of clinical data and will be supervised by licensed and/or certified staff
• Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs and ACOs
• Develop comprehensive, provider-specific plans to increase their HEDIS performance and improve their outcomes
• Provide ongoing strategic recommendations, training and coaching to provider groups on program implementation and barrier resolution
• 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 UHC program administration, use of plan tools, reports and systems
• Coordinate and lead Stars-specific JOC 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, 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 UHC 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
• Solid communication and presentation skills
• Solid relationship building skills with clinical and non-clinical personnel
• Other duties, as assigned

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.

• 3+ years of healthcare industry experience
• 1+ year of experience working for a health plan and/or for a provider's office
• 1+ year of HEDIS STARs experience
• Demonstrated intermediate or higher level of proficiency using Microsoft Office, specifically Word, Excel, Outlook, and Power Point
• Reside in the New Orleans LA regional area (routine travel is required in this area)
• Able/willing to travel approximately 75% in the New Orleans LA regional area (must live in this region to perform daily travel requirements)
• Proof of a valid Driver's License, access to reliable transportation and current auto insurance

• Medical/clinical background
• Proven solid knowledge of electronic medical record systems
• Consulting experience
• Proven solid knowledge of the Medicare market
• Demonstrated knowledge base of clinical standards of care, preventive health, and Stars measures
• Experience in managed care working with…