Join the UnitedHealthcare Team as a Practice Performance Manager - Medicare Consultant
At UnitedHealthcare, we're dedicated to simplifying the healthcare experience, creating healthier communities, and removing barriers to quality care. Our mission is to help people live healthier lives and make the health system work better for everyone. We're seeking a highly skilled and experienced Practice Performance Manager - Medicare Consultant to join our team in Lincoln, Nebraska, and work remotely.
About UnitedHealthcare
We're a leading health and well-being company that provides a wide range of health care services, including health insurance, health care delivery, and health services. Our company culture is built on the principles of caring, connecting, and growing together. We believe in fostering a diverse and inclusive work environment that encourages collaboration, innovation, and growth.
Role Overview
As a Practice Performance Manager - Medicare Consultant, you will play a critical role in program implementation and provider performance management. You will work closely with care providers to build relationships, ensure effective education and reporting, and proactively identify performance improvement opportunities. Your goal will be to influence provider behavior to achieve needed results, including 4-star gap closure and coding accuracy.
Key Responsibilities
- Function independently and travel across assigned territory to meet with providers and discuss UnitedHealthcare and Optum tools and incentive programs for risk adjustment and quality reporting.
- Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs, and ACOs.
- Develop comprehensive, provider-specific plans to increase their HEDIS performance, facilitate risk adjustment suspect closure, and improve their outcomes.
- Access PCOR and other reporting sources to analyze data, prioritize gap and suspect closure, identify trends, and drive educational opportunities.
- Conduct chart reviews quarterly and provide timely feedback to providers to improve reporting.
- Coordinate and provide ongoing strategic recommendations, training, and coaching to provider groups on program implementation and barrier resolution.
- Lead regular Stars and risk adjustment-specific JOC meetings with provider groups to drive continual process improvement and achieve goals.
- Provide reporting to health plan leadership on progress of overall performance, MAPCPi, MCAIP, gap closure, and use of virtual administrative resources.
Requirements and Qualifications
Essential Qualifications:
- 5+ years of healthcare industry experience.
- 2+ years of Medicare Advantage experience, including Stars and Risk Adjustment.
- 1+ year of provider-facing experience.
- Intermediate level experience with Microsoft Office, including Excel and PowerPoint.
- Certified Risk Adjustment Coder (CRC) or Certified Professional Coder (CPC) certification.
- Willing to travel up to 75-80% for business meetings and 20-25% remote work.
Preferred Qualifications:
- Registered Nurse.
- Experience working for a health plan or within a provider office.
- Experience with network and provider relations/contracting.
- Experience retrieving data from EMRs (electronic medical records).
- Experience in management or coding position in a provider primary care practice.
- Knowledge base of clinical standards of care, preventive health, and Stars measures.
What We Offer
As a Practice Performance Manager - Medicare Consultant at UnitedHealthcare, you can expect:
- A competitive salary and benefits package.
- Opportunities for career growth and professional development.
- A collaborative and dynamic work environment.
- A flexible work arrangement with remote work options.
- A chance to make a positive impact on the lives of millions of people.
Why Join UnitedHealthcare?
At UnitedHealthcare, we're committed to creating a healthier, more equitable world. We believe in fostering a culture of diversity, inclusion, and respect. Our company values are:
- Integrity: We act with honesty, transparency, and ethics in all our interactions.
- Respect: We treat each other with dignity and respect, valuing our differences.
- Accountability: We take ownership of our actions and results.
- Excellence: We strive for exceptional performance and continuous improvement.
How to Apply
If you're a motivated and experienced professional looking to make a difference in the healthcare industry, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and cover letter, to be considered for this role.
Don't miss this chance to join our team and be part of a company that's dedicated to helping people live healthier lives. Apply today and let's build the future together!
Apply Now