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UnitedHealth Group

UnitedHealth Group is looking for a Clinical Practice Consultant – Advanced Medical Home – Asheville – NC  #PagosaSpringsJobSearchEngine #JobsPagosaSprings #MedicalJobsPagosaSprings

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life’s best work.(sm)This position is responsible for strategically developing and managing clinically oriented provider and community-based partnerships in order to meet requirements of the Advanced Medical Home (AMH) Tier 3 program based on state specific guidelines. This role will be responsible for monitoring and providing ongoing oversight of the AMH Tier 3 program requirements of provider practices. This role will work in concert with the Local Health Department (LHD) Clinical Practice Consultants.The Clinical Practice Consultant will work closely with the Health Plan Clinical Leadership to coordinate an interdisciplinary approach to increase provider and program performance. This position will guide practices in achieving AMH Tier 3 program requirements through: oversight & performance monitoring, relationship management & engagement, education, and quality improvement. This position is accountable for driving practice progress toward desired transformational change and performance improvement, while meeting AMH program expectations outlined by the state. Position reports to the AMH Transformation Director.The Clinical Practice Consultant will be assigned to a specified Medicaid region within North Carolina. This is a work from home / telecommute position when not in the field but may require travel to State sponsored meetings and to the Greensboro or Raleigh office.The Advanced Medical Home program was developed by NC DHHS as the primary vehicle for delivering care management as the state transitions to Medicaid managed care.  The AMH program builds on the Carolina ACCESS program.  The tiers include Tier 1, Tier 2 and Tier 3: This position will focus on AMH Tier 3.If you are located in Asheville, NC you will have the flexibility to telecommute* as you take on some tough challenges.Primary Responsibilities: Drives execution of clinical practice transformation by overseeing timely and successful deployment of AMH program Provide oversight and performance evaluation through continuous monitoring and analysis of AMH Program and Quality Program requirements and development of strategies based on performance analysis Utilize monitoring, trending and performance improvement strategies to review progress of AMH providers, including specific Tier 3 requirements as defined by the State, and ensure the practice is accountable for successful implementation Provide ongoing support and develop recommended actions and best practices to assist the practice in achieving contractual requirements Regularly facilitate efficient, effective meetings with the practice to monitor, present, and discuss progress towards program requirements Build and effectively maintain relationships with the practice leadership and key clinical influencers actively involved in practice transformation through strategic partnerships Facilitates and participates in multi-disciplinary Joint Operational Committee meetings with external care management partners Serve as liaison and clinical resource using proven interpersonal and collaboration skills to foster relationships and maintain communication with multiple disciplines (e.g. Clinically Integrated Networks (CINs), internal UHC teams, external stakeholders, and other partners as appropriate) Consult and partner with internal UHC matrix partners and the practice to identify organizational and structural challenges hindering achievement of desired program outcomes Cross-collaborate on any identified or ongoing practice needs that require the involvement of a subject matter expert Provide education to promote quality and cost-effective outcomes around, but not limited to: Quality program and metrics, AMH Tier 3 program requirements – including Tier 3 progression, dissemination of the latest information on effective practices, and utilization of tools and resources to meet needs of the population (e.g. best practice guidelines, practice management support, population health program implementation, and/or with other appropriate resources) Implement basic quality improvement principles to provide technical assistance and support to improve practice performance while assessing trends in quality measures and identifying opportunities for quality improvement (e.g. AMH quality measures; value-based payment, access & availability, healthy opportunity and opioid strategies; EPSDT policies; and behavioral health integration) Uses a systematic approach to identify practice needs and opportunities, perform data analysis, and develops actionable solutions to improve quality outcomes Assist practices with analyzing and interpreting data to quickly identify problems, patterns, and high-risk activities Facilitate discussions around different data visualization strategies, including differences in databases, and basic data sharing and management of resources Support development, deployment and monitoring of State mandated performance improvement projects and other specific projects based on needs Document provider outreach and work in a shared customer relationship management system, utilize to inform UHC internal staff connections and to collaborate on mutual providers and identified intersection points Understand UHC and Optum provider-facing programs and processes to promote effective communication and collaboration Participates, coordinates, and / or represents the Health Plan at community-based organization events, clinic days, health department meetings, and other outreach events as assignedYoull 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: Bachelors Degree in healthcare related field or business combined with two years of equivalent work experience 5+ years clinical experience working with primary care practices, providing provider and liaison support 3+ years experience working with population health, patient centered medical homes (PCMH) and/or practice transformation efforts 2+ years of quality improvement experience with responsibilities in the following areas rapid cycle change, data analysis and interpretation, systems analysis, graphical display of data/information, public speaking, group leadership and facilitation, and demonstrated problem solving and critical thinking skills 2+ years experience working in Medicaid and/or Medicare or the managed care industry Previous experience in Health care and / or insurance industry experience, including regulatory and compliance Intermediate experience in software applications skills that include, Microsoft Word, Excel, PowerPoint Must be comfortable with creating presentations and working with data to formally present information to physicians, administrators, other providers and community partners, engaging different types of learners in various settings (e.g. practice offices, CIN/other partner offices, community settings This role requires travel to locally up to 75% of the time and may require travel up to 2 hours away from your residence on occasion If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attainedPreferred Qualifications: CPHQ or CCM Graduate degree Knowledge of one or more of: clinical standards of care, HEDIS, NCQA PCMH, and governing and regulatory agency requirements Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That’s why you’ll find some of the most amazingly talented people in health care here. We serve the health care needs of low- income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life’s best work.(sm)*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy. 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.Job Keywords: Advanced Medical Home, AMH, Clinical Practice Consultants, CPC, providers, auditing, performance measures, medical practices, care management, quality improvement, Plan-Do-Study-Act, (PDSA), travel, data, reporting, healthcare, insurance, Medicaid, Medicare, managed care, systems analysis, graphical display of data, CPHQ, CCM, clinical standards of care, HEDIS, NCQA, PCMH, governing, regulatory agency, North Carolina, NC Recommended SkillsLeadershipManaged CareMedicaidAnalysisCritical ThinkingComplex Problem SolvingRecommended JobsConsultantPractice ConsultantAtlanta,GaPractice Consultant, Atlanta,GaClinical Practice Consultant – Advanced Medical Home – Asheville – NCUnitedHealth GroupWork From HomeFull-TimeClinical Practice Consultant – Advanced Medical Home – Telecommute in Greensboro, NCUnitedHealth GroupAtlantaProject ManagerAtlanta

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