Think Beyond The Label Jobs

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.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Understand regional risk bearing entity strategy, quality incentive model and communicate effectively with contracted provider groups to drive engagement and kick off risk adjustment and full risk operational workflows

• Work with vendors and internal partners effectively to drive performance of KPIs across contracted and employed provider groups

• Develop presentations, data analysis and agendas to support monthly contracted and employed provider group meetings for key contracted and employed groups

• Prepare meeting materials and attend monthly payer meetings where performance, challenges and opportunities are highlighted and discussed

• Issue escalation process development and implementation across contracted and employed groups in partnership with the network managers

• Support process to ensure provider payment schedules, communication and payment delivery occur quarterly as expected

• Develop and iterate regional onboarding and training go live strategy for pre-risk and full risk contracted and employed provider groups to drive maximum pre-risk attestation submissions and decrease provider abrasion. Leverage communications, provider meetings, trainings etc.

• Develop structure for provider education strategy for risk adjustment, quality and clinical value/medical expense reduction in partnership with regional Medical Director

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:

• Licensed as a CPC or CRC

• Reside within the market, SC, NC, GA, TN, VA or MD

Preferred Qualifications :

• 3+ years of experience working in value based care role with risk adjustment, network contracting or quality STARS HEDIS

• Excellent MS Office Experience

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

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for this role is $104,700 to $190,400 annually. 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.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.