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Job Details


UnitedHealth Group

Field Based Senior Practice Performance Specialist - Las Vegas Metro Area

Healthcare

Family Practice

No

Las Vegas, Nevada, United States

Combine two of the fastest - growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making Healthcare data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life’s best work.SM

Employees in this position will work on-site or virtually as an extension of the local quality and provider teams by aligning to geographical regions, medical centers and/or physician practices that manage a high volume of UHC Medicare & Retirement membership. This position does not entail any direct member care* nor does any case management occur. (*with the exception of participating in health fairs and/or health screenings where member contact could occur).

This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am – 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends.

Primary Responsibilities:

  • Functioning independently, virtually meet with providers to discuss Optum 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.
  • 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.
  • Track appointments and document information completely and accurately in all currently supported systems in a timely manner.
  • Optimize customer satisfaction, positively impact the closing of gaps in care and productivity.
  • Partner with your leadership team, the practice administrative or clinical staff to determine the best strategies to support the practice and our members ensuring that recommended preventative health screenings are completed and HEDIS gaps in care are addressed
  • Interaction with UHC members via telephone to assist and support an appropriate level of care. This may include making outbound calls to members and/or providers to assist in scheduling appointments, closing gaps in care or chart collection activities.
  • Answer inbound calls from members and/or providers regarding appointments.
  • Communicate scheduling challenges or trends that may negatively impact quality outcomes.
  • Demonstrate sensitivity to issues and show proactive behavior in addressing customer needs.
  • Provide ongoing support and education to team members and assist in removing barriers in care.
  • Manage time effectively to ensure productivity goals are met.
  • Ability to work independently in virtual setting. Ability to problem solve, use best professional judgment and apply critical thinking techniques to resolve issues as they arise.
  • Identify and seek out opportunities within one’s own workflow to improve call efficiency.
  • Adhere to corporate requirements related to industry regulations/responsibilities.
  • Maintain confidentiality and adhere to HIPAA requirements.
  • Data analysis required for multiple system platforms to identify open quality opportunities to address on a member or provider level
  • Appointment coordination for specialist appointments, late to refill medication outreach and scheduling members for local market clinic events
  • Participate within department campaigns to improve overall quality improvements within measure star ratings or contracts.
  • Field based activities require the abilities to support appropriate targeted providers.
  • Work internally with support team on ad-hoc projects, initiatives, and sprints to address measure star ratings and increase overall measure performance
  • Participate and engage with team on member or provider campaigns which may include documentation tracking, member outreach, data analysis and data entry
  • Support incentive account owners on strategy development, feedback and participate within monthly meetings to give updates on member outreach or quality measure closures
  • Support EMR data exchange initiatives with incentive program owner to establish data communication between provider group and UHC
  • Weekly commitment of 60% travel for business meetings (including client/health plan partners and provider meetings) and 40% remote work.
  • 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.

Required Qualifications:

  • High School Diploma/GED (or higher)
  • 2+ years of telephonic customer service experience.
  • 1+ year of a healthcare background with medical terminology familiarity of clinical issues.
  • 1+ year of working experience with ICD- 9/10 and CPT Codes.
  • 1+ year of working experience with Microsoft Tools: Word and Outlook.
  • Experience with navigating, filtering and analyzing reports in Microsoft Excel.
  • 1+ year of working experience with and knowledge of HIPAA compliance requirements.
  • Strong data entry skills
  • Typing speed of at least 45-50 WPM.
  • Weekly commitment of 60% travel for business meetings (including client/health plan partners and provider meetings) and 40% remote work.
  • Ability to work an 8 hour shift between 8:00am – 5:00pm including the flexibility to work occasional overtime per business need

Preferred Qualifications:

  • Experience working in a physician, provider, and/or medical office is preferred.
  • Medical Assistant
  • LPN
  • EMR and HEDIS knowledge and experience

Soft Skills:

  • Demonstrated ability to identify with a consumer in order to understand and align with their needs and realities.
  • Demonstrated ability to perform effective active listening skills to empathize with the customer in order to develop a trust and respect.
  • Demonstrated ability to take responsibility and internally driven to accomplish goals and recognize what needs to be done in order to achieve a goal(s).
  • Demonstrated ability to turn situations around and go above and beyond to meet the needs of the customer
  • Good Attendance Record.

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet

Careers with OptumInsight. Information and technology have amazing power to transform the Healthcare industry and improve people's lives. This is where it's happening. This is where you'll help solve the problems that have never been solved. We're freeing information so it can be used safely and securely wherever it's needed. We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life’s best work.SM

Nevada Residents Only: The salary range for Nevada residents is $23.94 - $42.40. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.

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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