Practice Performance Support Specialist

UnitedHealth Group - Boston, MA (30 days ago)3.6


The ACO Practice Performance Support Specialist will provide support clinical relationships and engagement with physician practices, members, and pharmacies while partnering internally with other UnitedHealthcare shared services (such as Network contracting, Health Care Economics and Analytics, Medical Directors, Reporting teams, and Health Plan market leaders) with a goal of improving health, well-being, quality and practice performance while reducing medical costs. Positions are accountable for the full range of clinical practice performance which may include but is not limited to improvement on HEDIS and STARs gap closure, coding accuracy, medication reconciliation, facilitating effective education and reporting, effective super utilizer engagement (e.g., members with complex and/or chronic conditions), and proactively identifying performance improvement opportunities through the use of data analytics, technology, workflow changes and clinical support. These roles support the development of comprehensive, provider-specific plans to increase their physician practice performance, reduce readmissions and improve their outcomes.

If you are located in the Northeast region, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:
Download reporting from multiple systems to investigate and analyze health care data in support of Clinical Transformation Consultants

Provide verbal, written and chart explanations and observations of health care data

Work across various healthcare IT platforms e.g, Electronic Medical Records (EMR), Practice Management Software, Billing & Coding etc. within UnitedHealthcare and with practices and clinics

Train clinic or office staff on UHC tools and processes

Troubleshoot IT platform issues on behalf of practice and escalate remediation

Provide feedback in regards to business process or organizational inefficiencies and recommend solutions

Monitor and report progress on assigned tasks of internal teams and practice commitments

Coordinate, schedule, and prepare joint meetings between executive practice leadership, practice staff, and UHC Account Teams

Use pertinent data and facts to identify and solve a range of problems within area of expertise

Investigate non-standard requests and problems, with some assistance from others

Track and take action on open issues

Prioritize and organizes own work to meet deadlines

Provides explanations and information to others on topics within area of expertise

Provide Practice Facing, onsite support to improve quality and utilization metrics

Assist Practice in solving roster issues with Roster Management Teams

Assist Clinical Transformation Consultant in closing gaps in care

Assist Clinical Transformation Consultant with STARs discrepancy reviews

Manage Data setup, entry and maintenance in customer relationship management tool (IMPACT)

Manage data access requests for internal department and external clients, providing training as needed

Put forth recommendations internally to improve provider experience

Additional Responsibilities:
Build a positive working relationship with transformation consultants and practices you are assigned

Build a positive and collaborative relationship with Commercial, Medicaid and Medicare local and National Functions (Contracting, Product, and Operations)

Support market UHC health plan and accountable care community through events extending resources to address care needs for Commercial, Medicare and Medicaid

Potential to progress and obtain industry certifications

Required to have access to reliable transportation or valid driver’s license

This role is not member/patient facing

Air Travel expected less than 25%

Required Qualifications:
Bachelor's degree in applicable area of expertise or equivalent experience
1+ year of data analysis and/or reporting experience
Intermediate to advanced level Microsoft Excel skills
Proficient with Microsoft Word, Outlook and PowerPoint
Access to high speed internet for home office set up

Preferred Qualifications:
Clinic or physician practice experience
Knowledge of medical terminology and / or Knowledge of quality measures
Experience working in Healthcare industry
Project Management Experience
Experience working for a Health Plan
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)

  • 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.

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