26 Aug
Associate Healthcare Advocate - Shreveport, Louisiana
Louisiana, Shreveport

Vacancy expired!

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

The Associate Healthcare Advocate is responsible for a range of provider relations services within Optum. The Associate Healthcare Advocate will work as an extension of the local Provider Performance Team by aligning to geographical regions, medical centers and/or physician practices that manage a high volume of membership. The Associate Healthcare Advocate under the supervision of a Director/ Manager and or Mentor is responsible for the successful program implementation, compliance with network requirements, network assessment and selection, and program/product implementation.

Primary Responsibilities:

  • Manage 50-75 provider groups in a defined market, limited to groups with < 250 members

  • Assist the licensed and/or certified staff/Director/HCA or Mentor in the review of medical records to highlight opportunities for the medical staff

  • Locate medical screening results/documentation to ensure the closure of gaps in care/suspect medical conditions. Will not conduct any evaluation or interpretation of Clinical data and will be supervised by licensed and/or certified staff

  • Activities may include data collection, data entry, quality monitoring, HQPAF submission and chart collection activities

  • Partner with your leadership team, the practice administrative or clinical staff to determine best strategies to support the practice and our members

  • Utilizing data analysis, identify and target providers who would benefit from our coding, documentation and quality training and resources

  • Develop comprehensive, provider-specific plans to improve performance

  • Anticipate customer needs and proactively develop solutions to meet them

  • Optimize customer satisfaction, positively impact the closing of gaps in care and productivity

  • Manage time effectively to ensure productivity goals are met

  • Ability to problem solve, use best professional judgment and apply critical thinking techniques to resolve issues as they arise Adhere to corporate requirements related to industry regulations/responsibilities

  • Maintain confidentiality and adhere to HIPAA requirements

  • Collaborate with doctors, coders, facility staff and a variety of internal and external personnel on a wide scope of Risk Adjustment and HEDIS education efforts

  • Function independently, meeting with physicians to discuss OPTUM tools and programs focused on improving the quality of care for Medicare & Medicaid Advantage Members

  • Mentor Health Service Coordinators

  • Educate providers on how to improve their Risk Adjustment Factor (RAF) scores and HEDIS/STARS performance

  • Ability to travel within assigned territory (day trips) 80% of the time

  • Other duties, as assigned

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:

  • Undergraduate degree or equivalent work experience

  • 1 year of a healthcare background with medical terminology familiarity of clinical issues

  • 1 year of working experience with Microsoft Tools: Word, Excel and Outlook

  • 1 year of working experience with and knowledge of HIPAA compliance requirements

  • Knowledge of Managed Care and Medicare programs; prior experience with commercial and Medicare regulations

  • 3 years of provider network management, physician contracting, healthcare consulting, Medicare Advantage sales or Pharmaceutical sales experience

  • Experience working in a physician, provider, and/or medical office

  • EMR and HEDIS knowledge and experience

  • Demonstrated ability to identify with a consumer in order to understand and align with their needs and realities

  • Demonstrated ability to perform effective active listening skills to empathize with the customer in order to develop a trust and respect

  • Demonstrated ability to take responsibility and internally driven to accomplish goals and recognize what needs to be done in order to achieve a goal(s)

  • Demonstrated ability to turn situations around and go above and beyond to meet the needs of the customer

  • Ability to work independently and remain on task; ability to prioritize and meet deadlines

  • Project management experience

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.

Keywords: performance manager, Shreveport, LA, Louisiana

Vacancy expired!