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Job Details


UnitedHealth Group

Care Value and Optimization Consultant - Hybrid - Austin, TX

Healthcare

Acute Care

Yearly

No

Austin, Texas, United States

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)

The Care and Value and Optimization Consultant (CVO) Consultant) researches and investigates critical business problems through quantitative analyses of revenue, utilization metrics, healthcare costs, membership trends, and quality and risk adjustment data. The CVO Consultant provides management with statistical findings and conclusions and partners with stakeholders to identify areas of opportunity to improve the financial performance of clinics and risk pools. CVO Consultant also develop recommendations and strategies and communicates findings to leadership and operations teams to help implement corrective action plans.

Primary Responsibilities:

  • Demonstrate understanding of a provider’s business goals, contracting, performance metrics/scorecard, industry trends, and WellMed business model
  • Coaches and provides the translation of financial data to guide action
  • Assist with contracted and affiliated efforts
    • Market contracting strategy
    • Assist PBMs with financial education, meeting presentations, and identifying areas of opportunities
    • Corrective action plan for pools
    • Analysis of yearly contracted pool structure
      • Pool movement and restructuring impact
      • Compliance of pool criteria and structure
  • Monitors and reviews metric performance for Hospital and Specialty Joint Operating Committees (JOC)
  • Conduct financial and HCE training for new providers and staff
  • Partner with market dyads on market-wide initiatives
  • Act as SME over market financials and support leadership on strategic projects and decisions
  • Develop tracking metrics and perform analysis of special projects
  • Monthly or weekly report card/analysis packet
  • Support market meetings: Strategic meetings, Contracted Pool meetings, and Monthly Market Success meetings (MSM) and/or Grand Rounds (GR)
  • Performs all other related 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.

Required Qualifications:

  • Bachelor’s Degree, Finance, Accounting, Business Administration, Healthcare Administration, or related field (4+ additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor’s degree)
  • 3+ years of general healthcare data analysis experience
  • 2+ years of experience in a reporting and analytical role
  • Knowledge of Managed Care and Medicare programs
  • Understanding of the complexity of Member healthcare claims
  • Ability to conduct performance evaluation to identify performance measures or indicators and the actions needed to improve or correct performance, relative to the goals
  • Proficient in MS Excel and/or equivalent data capture/reporting tools
  • Ability to travel up to 75% within assigned market
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

  • 3+ years of experience in a clinical setting
  • Risk Adjustment knowledge related to CMS reimbursement models
  • Ability to act as a mentor to others
  • Ability to communicate and facilitate strategic meetings with groups of all sizes
  • Solid verbal and written communication skills
  • Ability to work independently, use good judgment and decision making process

Physical & Mental Requirements:

  • Ability to lift up to 25 pounds
  • Ability to push or pull heavy objects using up to 25 pounds of force
  • Ability to sit for extended periods of time
  • Ability to stand for extended periods of time
  • Ability to use fine motor skills to operate office equipment and/or machinery
  • Ability to properly drive and operate a company vehicle
  • Ability to receive and comprehend instructions verbally and/or in writing
  • Ability to use logical reasoning for simple and complex problem solving


To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment


Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.


Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

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

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