Provider Enablement Consultant - Licensed Behavioral Health Clinician or RN - Telecommute
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 is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)
The Provider Enablement Consultant (PEC) is responsible for the ongoing clinical management and quality oversight of Optum’s value-based programs. The PEC will be responsible for developing relationships with participating behavioral health providers and facilities, and driving a quality improvement process to improve quality, improve clinical outcomes, increase efficiency and reduce overall benefit expense. The PEC will monitor provider performance and compliance with contractual obligations, provide tools to assist with performance and compliance, and is accountable for driving provider performance improvement. As the single point of clinical contact for a provider, the PEC will be responsible for communicating progress towards achievement of targeted goals to Senior Leadership both within Optum and the participating provider.
The PEC must demonstrate strong clinical and analytic skills, strong oral and written communication skills and must be comfortable working closely with senior leaders at high volume facilities/groups and/or providers. This PEC will work closely with Care Advocacy Operations, Affordability, Network Management teams and other relevant departments to affect desired outcomes with the participating provider as it relates to treatment for our membership.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
- Build and effectively maintain relationship with the provider leadership and key clinical staff
- Regularly facilitate oversight meetings with the provider to monitor, present, and discuss performance
- Monitoring provider performance on program metrics, quality outcomes and adherence to contract requirements
- Conduct provider program audits and provide feedback and results
- Identify performance improvement opportunities through analysis of operational data, clinical outcome data and utilization/claims data
- Communicate with providers to initiate interventions focused on improvement of clinical outcomes and efficiency, as well as compliance with contractual obligations
- Initiate and monitor Quality Improvement Plans to drive performance
- Monitor and report effectiveness of interventions
- Modify interventions as appropriate
- Support those high performing providers such that performance remains at a high level
- Provide clinical and care coordination support
- Deliver education and training
- Interface with other OHBS departments including Care Advocacy, Affordability, Clinical Network Services, Program and Network Integrity, and Quality Improvement.
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.
- Independently licensed behavior health clinician including: LISW, LICSW, LPC, LPCC, LMFT, PsyD or, an RN with behavioral health experience
- License must be active and unrestricted in state of residence
- Experience in interpreting and utilizing clinical data analytics, outcomes measurement in healthcare and use of that data to drive change
- Experience identifying performance improvement opportunities and influencing quality metrics
- Demonstrated experience leading groups and solid presentation skills
- Solid computer skills at the intermediate level, proficiency with MS Office
- 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
- 3+ years of Managed Care and/or Case Management experience in a Managed Care setting is highly preferred with experience working with facility/group based care advocacy
- 3+ years post licensure direct behavioral health clinical experience
- Working knowledge of Public Sector benefit plans
- Solid relationship building and influencing skills
- Solid written and verbal communication skills
- Excellent time management and prioritization skills
- Ability to balance contractual and clinical considerations
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 Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $66,100 to $118,300. The salary range for Connecticut / Nevada residents is $72,800 to $129,900. 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.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy
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.