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The Senior Clinical Transformation Consultant (SR CTC) is responsible for the ongoing clinical management of physician practices participating in UnitedHealthcare's (UHC) Accountable Care Organizations (ACO), Value Based Programs, Patient Centered Medical Homes (PCMH), or Population Health Management programs such as Patient Centered Care Model.
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Work with the practice and Optum to align and integrate Optum care/disease management programs and population health services to augment the practice's capabilities, support their care management efforts and add value to the patient care experience.
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General knowledge of clinical programs, trends and medical management, medical care delivery systems, utilization management, disease management, analytics quality management, contracting, provider relations and customer service.
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We have over 60 locations and board certified medical providers specializing in Adult Medicine, Pediatrics, ENT, Foot & Ankle, Gastroenterology, Rheumatology, Cardiology, Behavioral Health, Physical Therapy, Allergy & Immunology, Developmental Health, Pain Management, Endocrinology, Chiropractic and Optometry.
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In support of the Midwest Region Risk Bearing Entity (RBE) mission, vision, and strategic goals to achieve the quadruple aim by focusing on value-based care, the Network Medical Director provides clinical leadership in the adoption of the key principles, tools, technologies, and clinical support services essential to the population health management of their designated market(s.
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The Case Manager (CM) / Utilization Review (UR) nurse staff augmentation full time role will temporarily fill in for Optum care management teams for short term staffing as well as provide consultative support to the front-line care management team, as appropriate.
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In collaboration with Optum Health Care Delivery Organizations and Optum Rx this role leads pharmaceutical strategy (GSK, Pfizer, vaccines, oncology, generic injectables, etc.) The Director, Pharmacy Category Management is accountable for leading Optum Health's >$1B in annual enterprise pharmacy category spend.
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During each assignment, the role will provide comprehensive care management or utilization review services in various locations. Provide consulting services in care management redesign with the frontline team members.
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Primary Responsibilities: Hospital and medical group engagement and relationship management Collaborate with hospital-based physicians and other stakeholders (e.g., nurses, case managers, social workers) to coordinate care transitions from the outpatient and inpatient environmentsProvide strategic direction to navigate conversations and drive alignment across multiple stakeholder groups (Optum Health, Hospitals, SNF’s, Home Health Vendors, etc.
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Through innovation and superior care management, Reliant is at the forefront of value-based care with a business model of patient-centric and physician-led care teams focused on their patients' total well-being rather than productivity.
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20,000 Sign on Bonus or up to $40,000 School Loan Repayment Part-time or Full-time opportunity Optum Home & Community Care , part of the UnitedHealth Group family of businesses, is creating something new in health care.
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Regularly meet with naviHealth's leadership to review care coordination issues, develop collaborative intervention plans, and share ideas about network management issues. Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care.
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An understanding or familiarity with managed care or population health management principles and reimbursement mechanics. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.
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Understanding of population-based medicine, preferably with knowledge of CMS criteria for post-acute care. At naviHealth, our mission is to work with extraordinarily talented people who are committed to making a positive and powerful impact on society by transforming health care.
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Implements HEDIS measure campaigns and other quality initiatives as directed by Corporate Health Services to ensure the highest standards of care and to promote the improvement of care management and delivery.
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care management jobs Company: Unitedhealth Group in Liberty, Missouri
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