Sr. Provider Engagement Specialist - Jackson, TN - Remote

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to startCaring. Connecting. Growing together.This position functions as a subject matter expert in Client Service operations. The role strives to bring consistency and experience to existing Provider Engagement Specialists in the local market by analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning. It organizes and assists assigned provider groups and/or financial pools, as well as fellow account managers, in achieving short‐ and long‐term operational and strategic business goals by developing, enhancing and maintaining operational information and models. In conjunction with the local Client Services Associate Director and/or Director, it develops and implements effective, strategic business solutions through research and analysis of data and business processes. The Senior Provider Engagement Specialist maintains a strong day‐to‐day relationship with stakeholders, providers, and office staff to effectively implement business solutions developed by the Optum leadership team. The Senior Provider Engagement Specialist is accountable for overall performance and profitability for their assigned provider groups and/or financial pools.If you are located in the Jackson, TN area, you will have the flexibility to work remotely. For hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.Primary ResponsibilitiesData analysis required to support, compile and report key informationDrive processes and technology improvement initiatives that directly impact Revenue, HEDIS/STAR measures and Quality Metrics, using standard project methodology (requirements, design, test, etc.)Use data to identify trends, patterns and opportunities for the business and clients; develop business strategies in line with company strategic initiativesEngage provider staff and providers in analysis and evaluation of functional models and process improvements; identify dependencies and prioritiesEvaluate and drive processes, provider relationships and implementation plansProduce, publish and distribute scheduled and ad‐hoc client and operational reports relating to the development and performance of productsCollaborate with other Client Services leads to foster teamwork and build consistency throughout the marketServe as a liaison to the health plan and all customersRequires strong presentation skills, problem solving and ability to manage conflict and identify resolutions quicklyHave the ability to communicate well with physicians, staff and internal departmentsEssential Job FunctionsAnalyze risk pool and/or provider group performance to determine areas of focus or improvement opportunities, including analysis of financial statements and other metric‐related reportsDevelop strategies and create action plans that align provider pools and groups with company initiatives, goals (revenue and expense) and quality outcomesDrive processes and improvement initiatives that directly impact revenue, HEDIS/STAR measures and quality metrics, coding and documentation processes, and educational improvementsUse and analyze data to identify trends, patterns and opportunities for the business and clients, and collaborate with colleagues and business partners to identify potential root cause of issuesCollaborate with internal clinical services teams, alongside Client Services leaders, to monitor utilization trends and risk pools to assist with developing strategic plans to improve performanceAssist provider groups with investigating standard and non‐standard requests and problems, including claims and member support servicesMaintain effective support services by working effectively with the Director of Client Services, Regional Medical Director, Clinical Services team, Operations and other corporate departmentsDemonstrate understanding of providers' business goals and strategies in order to facilitate the analysis and resolution of their issuesPerform all other related duties as assignedRequired Qualifications5+ years of experience in a related medical field or health plan setting (network management, contracting and/or recruitment, provider relations or in medical practice)Experience with Medicare health care operations including HEDIS, CMS reimbursement models, and Medicare AdvantageExperience developing long‐term positive working relationshipsExperience communicating and facilitating strategic meetings with groups of all sizesExperience working independently, using good judgment and decision‐makingExperience conducting performance evaluations to identify performance measures or indicators and the actions needed to improve or correct performance, relative to the goalsExperience resolving complete problems and evaluating options to implement solutionsProficiency in Microsoft Word, Excel and PowerPointKnowledge of state and federal laws relating to MedicareReliable transportation and ability and willingness to travel, both locally in assigned territory and non‐locally, as determined by business need up to 70%Permanent residence within a commutable distance to Jackson, TNPreferred Qualifications3+ years of Healthcare management experienceExperience acting as a mentor to othersClient Management experience*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. The salary for this role will range from $72,800 to $130,000 annually based on full‐time employment. Benefits include a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The company complies with all minimum wage laws as applicable.UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.UnitedHealth Group is a drug‐free workplace. Candidates are required to pass a drug test before beginning employment.#J-18808-Ljbffr