Senior Practice Performance Manager – Field Based in Irvine, CA

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.  

 

This role is responsible for implementing programs and managing provider performance, measured by key metrics such as 4 STAR gap closure and coding accuracy. The individual will work directly with care providers to build solid relationships, deliver education and reporting, identify performance improvement opportunities through data analysis and expert collaboration, and influence provider behavior to drive results. This position does not involve direct member care or case management, except for occasional participation in health fairs or screenings where member interaction may occur.

 

This is a field-based role in Irvine, CA with 3–4 days spent in the field and 1 day working from a home office.

 

Primary Responsibilities:

• Develop tailored business plans for provider groups across all levels of sophistication
• Analyze and interpret STARs and HEDIS data, providing executive summaries to internal teams and provider groups
• Serve as the primary point of contact for all STARs-related activities within assigned markets, collaborating across a matrixed organization including UHC RVPs, Regional Presidents, Virtual Admin/Call Center Teams, UHN, Health Plan Medical Directors, and other Optum and Health Plan stakeholders
• Support the development of training and analytical tools for STARs and HEDIS initiatives
• Operate independently with minimal supervision
• Lead regular business review meetings (weekly to annually) to present provider and market performance, either at Joint Operating Committees or directly to Health Plan leadership
• Report directly to the Optum Manager of Market Consultation and/or the Manager of STARs

 

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:

• 5+ years of healthcare industry experience
• 3+ years of STARs experience 
• 3+ years of experience working for a health plan and/or for a provider’s office
• Demonstrated consulting experience
• Proven knowledge of the Medicare market
• Valid Driver’s License, access to reliable transportation and current auto insurance
• Willing to travel approximately 75% of the time in the Irvine, California Regional Area (must live in this area to perform daily travel expectations)

 

Preferred Qualifications:

• Medical/clinical background
• Proven solid knowledge of electronic medical record systems
• Proven knowledge base of clinical standards of care, preventive health, and Stars measures
• Experience in managed care working with network and provider relations/contracting
• Proven solid problem-solving skills
• Proven solid financial analytical background within Medicare Advantage plans (Risk Adjustment/STARS Calculation models)
• Proven solid communication and presentation skills
• Proven solid relationship building skills with clinical and non-clinical personnel
• Microsoft Office specialist with exceptional analytical and data representation expertise; Advanced Excel, Outlook, and PowerPoint skills required

 

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

 

The salary range for this role is $89,800 to $176,700 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

 

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.

 

 

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.