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The Clinical Practice Performance Analyst develops relationships with provider partners to monitor, influence and advance their abilities to deliver improved member outcomes.
This role works with their Director or Manager to ensure that contracted providers are engaged with the health plan and members are receiving high-quality health services that meets their needs. CTCs are assigned to a portfolio of ACO’s, Community-based Primary Care Physicians, Specialists, Acute or Post-Acute providers to manage based on needed engagement. The CTC should work with assigned provider portfolio to identify performance opportunities, develop their capabilities and, as applicable, innovate existing care delivery shifting from fee for service through the value realization continuum of shared savings to shared risk arrangements.
*** Expect to spend about 50% of your time in the field visiting our providers at their location.***
- Serves as liaison to Providers and is responsible to develop, foster and maintain relationships with contracted Providers and office staff to ensure Provider adherence to contractual requirements
- Understand, determine role & accountability, and successfully Implement the organization’s business objectives related to provider engagement to achieve revenue, affordability, provider engagement and satisfaction targets
- Accountable to successful implementation and achieving results of Provider Incentive programs
- Work with Director or Manager to develop reports of actionable data for each provider to stratify and then prioritize members for care management outreach (related to quality, risk score & utilization management)
- Properly engage, orient and onboard providers (after contracted), to effectively introduce them to participation requirements and procedures
- Engage provider partners to adopt technology tools and applications to simplify and digitize their experience
- Develop and implement process improvement specific to provider practice to achieve accountable care goals
- Collaborate with care coordination teams to effectively address immediate and emergent member needs
- Collaborate with network contracting regarding network changes, terminations, deficiencies, and other contract modifications
- Collaborate with provider call services and internal stakeholder departments to identify and resolve provider issues implementing pro-active solutions to complaints or issues
- Working with contracted providers, CTC Daily Activities consist of:
- Assess capabilities and drive improved population health activities
- Monitor, strategize and implement improvement opportunities around key cost, utilization, and quality metrics
- Share actionable data and make recommendations for improved member care basis on this data
- Conduct training and education to new & existing providers as needed, including providing access to education modules
- Seamlessly adopt new technology tools and solutions that support quality improvement
- Performs other duties as requested by management
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.
- High school or General Equivalency Diploma
- Ability to quickly learn key Medicare Advantage business fundamentals and provider contract payment structures & typical provider contractual obligations
- Negotiation and Influential Ability – Uses persuasion to gain the support and cooperation from stakeholders, superiors, colleagues, subordinates, and other parties to achieve a desired course of action consistent with the organization's strategic goals and objectives. Demonstrates ability to influence others when appropriate
- Judgment – displays willingness to make decisions, exhibits sound and accurate judgment and makes timely decisions
- Planning/organizational skills – prioritizes and plans work activities, uses time efficiently and develops realistic action plans
- Oral/written communication skills – Speaks and writes in a professional, clear, and persuasive manner. Demonstrates above average individual and group presentation skills when conducting meetings, leading a team, or working with peers
- Solid interpersonal skills
- 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
- College degree
- Managed care and/or experience dealing with hospitals, physicians and/or ancillary providers
- Project management experience
- Demonstrated proficiency with Microsoft Office applications for the creation of reports and presentations
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 at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in health care. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.(sm)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $54,400 to $97,000. The salary range for Connecticut/Nevada residents is $60,000 to $106,700. 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.