Account Manager, Client Services

*** TELECOMMUTE WITH RESTRICTIONS: Candidates must reside in Ohio with a preference for the North Eastern Ohio market. ***

OptumCare is a rapidly growing national, integrated health care organization that helps physicians and other providers deliver the right care at the right time in the right setting. We design and manage delivery systems in markets where we can achieve the Quadruple Aim - a better patient experience, higher quality care, lower costs, and a better experience for providers. With our expertise and resources, we are on the front lines transforming the health care delivery system to help improve the overall health of patients and communities.

This physician led, patient centric, and data driven business creates value by delivering and facilitating care across the full continuum through high performing networks comprised of owned, managed and contracted physicians, advanced practitioners and other providers. Our system impact extends across physicians, specialty care, urgent care, home health, post-acute transitions, complex care in skilled nursing facilities and palliative care.

The Account Manager, Client Services has geographic responsibility for the quality and economic performances of the physician practice with the goal of developing a high performing provider network within the State of Ohio. This includes analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning. Along with engaging the provider members through the on-boarding process with an effective transition from the Network Development and Engagement area. The PBM will develop and sustain a strong day-to-day relationship with stakeholders, the physician and office staff to effectively implement the business solutions developed by Optum leadership team. The PBM is accountable for overall performance and profitability for their assigned groups as well as ownership and oversight to provide redirection as appropriate and approved. The responsibilities of this position include capabilities in the following areas: strategic planning and analysis; understanding of HEDIS, Star ratings, RAF Score and coding; highly developed communication skills; and the ability to develop clear action plans and drive process.

All positions of Optum includes working collaboratively with the Medical Director to achieve improved performance on the elements of the triple aim consisting of total cost of care management, quality outcomes, and patient experience for our customers; employers and patients.

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

Primary Responsibilities:

• Aligns contracted providers with initiatives, goals (revenue/expense) and quality outcomes
• Uses pertinent data and facts to identify and solve a range of operational issues within the provider practices
• Builds strategic relationships and partnerships with providers to work as a team in order to provide improved value to our patients and develop a competitive differentiation to position us as the value based organization of choice
• Maintains open communication with providers to include solutions for resolution and closure on health plan issues related to credentialing, eligibility, disease management, utilization management, quality and risk adjustment programs
• Drive processes and technology improvement initiatives that directly impact Revenue, HEDIS/STAR measures and Quality Metrics
• Engage providers and staff in the analysis and evaluation of functional models and process improvements
• Identifies and evaluates business opportunities and maintain contacts with healthcare providers to build innovative partnerships and programs that deliver value in new ways
• Provides assistance and guidance on the development of collateral material that demonstrates the value proposition that ensure improved patient-centered care, including appropriate preventive services, referral management, wellness initiatives, and population health management

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:

• 3+ years of provider relations or managed care experience
• Solid knowledge of local provider community
• Ability to travel regularly to provider offices in the designated market
• Full COVID-19 vaccination is an essential requirement of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance

Preferred Qualifications:

• Bachelor's degree in Healthcare, Business Administration or related field OR comparable combination of education and work experience.
• Medical practice manager
• Experience with private and employed physician models and care redesign including care management and patient care
• Understanding of IPAs, Clinically Integrated Networks, Medicare Shared Savings Programs, capitation/value-based contracting, and narrow networks
• Microsoft Office/Excel proficiency
• Presentation skills to small and large groups
• Professional provider relations experience involving physicians and administrative staff
• Exceptional interpersonal skills with ability to interface effectively both internally and externally with a wide range of people including physicians, office staff, hospital executives and other health plan staff
• Excellent analytical and problem solving skills with effective follow through
• Solid verbal and written communication skills

Proof of immunity to vaccine-preventable diseases is an employment requirement.

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

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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