Field Clinical Practice Performance Specialist – Omaha, Nebraska

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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

This is a field-based position traveling to physician practices. Advocates review charts (paper and electronic – EMR), look for gaps in care, perform STARs assessments, help coordinate doctor appointments, make follow-up calls to members after appointments, and assist our members in overall wellness and prevention. Practice based support staff primarily work at physician practices daily. This position does not entail any direct member care, nor does any case management occur.

If you are in Nebraska, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

• Provide care coordination through physician practices for members to improve clinical quality and clinical documentation
• Conduct telephonic member needs assessments according to state and national guidelines, policies, procedures, and protocols
• Interact with members via telephone; Schedule appointments, follow up calls to assess understanding of services, answer questions and ascertain that additional procedures have been completed that relate to preventative health screenings or HEDIS gaps in care
• Review member charts prior to a physician appointment and create alerts/triggers to highlight Star opportunities for the practice
• Partner with the practice’s administrative and clinical staff while managing member appointments and data between visits
• Create and maintain a professional and supportive relationship with the member, provider and office staff 
• Facilitate appropriate member referrals to special programs such as Behavioral Health, Advanced Illness and Social Services
• Assist the member to access community, Medicare, family and other third-party resources as appropriate
• Collaborate and communicate with the member’s health care and service with our interdisciplinary delivery team to coordinate the appointments, screening or care related to preventative health screenings or HEDIS gaps in care
• Provide education to members regarding health care needs and available services related to preventative health screenings or HEDIS gaps in care
• Work to facilitate member compliance with their appointments, screenings, medications and/or action plans to complete open care opportunities/HEDIS gaps in care
• Identify barriers for compliance in preventative health screenings or HEDIS gaps in care and communicates with members and providers to formulate action plan to address
• Document member conversations and activities in Optum/UHC programs; No documentation in provider EMRs and/or member charts
• Maintain a focus on timely, high-quality customer service
• Maintain the confidentiality of all sensitive information

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:

• High School Diploma/GED (or higher)
• 2+ years of experience working in a hospital, acute care or healthcare
• 2+ years of experience working in a customer service/call center role
• Intermediate level of computer/typing proficiency to enter/retrieve data in electronic clinical records; experience with email, internet research, use of online calendars and other software applications including MS Office and Excel
• Ability to travel to provider offices within service area – may require up to 2-hour radius for travel
• Access to reliable transportation and possess a valid US driver’s license

Preferred Qualifications:

• Associates degree or higher
• Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
• Experience with HEDIS and EMR (electronic medical records)
• Experience with navigating and analyzing reports in Microsoft Excel
• Medicaid, Medicare, Managed Care experience
• Prior Physician office experience 
• Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
• Call Center experience
• Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
• Demonstrated ability to identify with a consumer to understand and align with their needs and realities
• Demonstrated ability to perform effective active listening skills to empathize with the customer to develop a trust and respect
• Demonstrated ability to take responsibility and internally driven to accomplish goals and recognize what needs to be done to achieve a goal(s)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

 

The salary range for this role is $23.70 to $46.35 per hour 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.

 

 

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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