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UnitedHealth Group Clinical Practice Performance Analyst - Remote in Baton Rouge, LA in Baton Rouge, Louisiana

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

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. Clinical Practice Performance Analyst 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 Clinical Practice Performance Analyst 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.*

If you are located in Baton Rouge, LA or within a commutable driving distance, you will have the flexibility to work remotely* as you take on some tough challenges..

Primary Responsibilities:

  • 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, Clinical Practice Performance Analyst 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.

Required Qualifications:

  • Ability to quickly learn key Medicare Advantage business fundamentals and provider contract payment structures & typical provider contractual obligations

  • Proven negotiation and influential ability – Ability to use 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. Demonstrated ability to influence others when appropriate

  • Demonstrated solid judgment – ability to display willingness to make decisions, exhibits sound and accurate judgment and makes timely decisions

  • Proven solid planning/organizational skills – ability to prioritize and plan work activities, use time efficiently and develop realistic action plans

  • Proven oral/written communication skills – Ability to speak and write 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

  • Proven solid interpersonal skills

  • Reliable transportation and the ability to travel locally up to 50% of the time

Preferred Qualifications:

  • 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

  • Understanding of Medicare STAR Ratings, HEDIS Measures, Medical Coding and Documentation

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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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