Sr. Provider Engagement Specialist - Roanoke, VA

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 start Caring. Connecting. Growing together.This position functions as a subject matter expert in Client Service operations. This position 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. This position will organize and assist assigned provider groups and/or financial pools, as well as fellow account managers, in achieving short and long term operational/strategic business goals/ by developing, enhancing and maintaining operational information and models. They also develop and implement, in conjunction with the local Client Services Associate Director and/or Director, effective/strategic business solutions through research and analysis of data and business processes. The Senior Provider Engagement Specialist will develop and sustain a solid day-to-day relationship with stakeholders, the 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.Essential Job FunctionsAnalyze risk pool and/or provider group performance to determine areas of focus or improvement opportunities, to include performing analysis of financial statements and other metric-related report to determine areas of focus or improvement opportunitiesDevelops 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 process and educational improvementsUse and analyze data to identify trends, patterns and opportunities for the business and clients, and collaborating and/or participating in discussions with colleagues and business partners to identify potential root cause of issuesCollaborates with internal clinical services teams, alongside Client Services leaders, to monitor utilization trends and risk pools to assist with developing strategic plans to improve performanceAssists provider groups with investigating standard and non-standard requests and problems, to include claims and member support servicesMaintains 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 issuesPerforms all other related duties as assignedIf you are located in Roanoke, VA, you will have the flexibility to work remotely* as you take on some tough challenges. For all 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 marketServes as a liaison to the health plan and all customersRequires solid presentation skills, problem solving and ability to manage conflict and identify resolutions quicklyHave the ability to communicate well with physicians, staff and internal departmentsYou'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 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-making Experience 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 solutionsKnowledge of state and federal laws relating to MedicareProficiency in Microsoft Word, Excel and PowerPointReliable 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 Roanoke, VAPreferred Qualifications3+ years of healthcare management experienceExperience acting as a mentor to othersClient Management experienceAll employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter PolicyPay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.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.OptumCare 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.OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.