Field-Based Senior Practice Performance Specialist in Pittsburgh, PA

Field-Based Senior Practice Performance Consultant in Pittsburgh, PA and Surrounding Areas

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts on the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. 

Employees in this position will work on-site or virtually as an extension of the local quality and provider teams by aligning geographical regions, medical centers and/or physician practices that manage a high volume of UHC Medicare & Retirement membership.

As a Senior Practice Performance Consultant, you will be responsible for partnering with practice admin or clinical staff to review medical records and help close HEDIS gaps in care for Medicare members. This position does not entail any direct member care nor does any case management occur.

This is a field-based position based in Pittsburgh, PA and surrounding areas

Travel expectation is 75% of the time if needed

Training: 4 weeks of paid virtual training

Work Schedule: Monday - Friday, 8 hours between 8am - 6pm EST

If you reside within Pittsburgh PA, you will enjoy the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

• Partner with your leadership team, the practice administrative or clinical staff to determine the best strategies to support the practice and our members ensuring that recommended preventative health screenings are completed and HEDIS gaps in care are addressed
• Functioning independently, virtually meet with providers to discuss Optum tools and programs focused on improving the quality of care for Medicare Advantage Members
• Execute applicable provider incentive programs for health plan
• Assist in the review of medical records to highlight Star opportunities for the medical staff
• Activities include data collection, data entry, quality monitoring, upload of images, and chart collection activities
• Locate medical screening results/documentation to ensure quality measures are followed in the closure of gaps. Will not conduct any evaluation or interpretation of Clinical data
• Track appointments and document information completely and accurately in all currently supported systems in a timely manner
• Optimize customer satisfaction, positively impact the closing of gaps in care and productivity
• Interaction with UHC members via telephone to assist and support an appropriate level of care. This may include making outbound calls to members and/or providers to assist in scheduling appointments, closing gaps in care or chart collection activities
• Answer inbound calls from members and/or providers regarding appointments
• Communicate scheduling challenges or trends that may negatively impact quality outcomes
• Demonstrate sensitivity to issues and show proactive behavior in addressing customer needs
• Provide ongoing support and education to team members and assist in removing barriers in care
• Manage time effectively to ensure productivity goals are met
• Ability to work independently in virtual setting. Ability to solve problems, use best professional judgment and apply critical thinking techniques to resolve issues as they arise
• Identify and seek out opportunities within one's own workflow to improve call efficiency.
• Adhere to corporate requirements related to industry regulations/responsibilities
• Maintain confidentiality and adhere to HIPAA requirements
• Data analysis required for multiple system platforms to identify open quality opportunities to address on a member or provider level
• Appointment coordination for specialist appointments, late to refill medication outreach and