Job: Market Program Consultant--Network Provider Outreach--Raleigh-Durham, NC Area

This posting has expired and is no longer available.

Browse Similar Jobs: Other/General

Jobing Description

What makes your Network career greater with UnitedHealth Group? Growth opportunities among the variety of product lines and making an impact on the healthcare system ensures it will always be challenging and exciting. The Network Program Consultant is responsible for the successful program design, compliance with network requirements, network assessment and selection, and program/product implementation. This includes enterprise-wide Clinically Integrated Network teams that focus on specific clinical area Lines of Service (e.g., Cardiology, Women's Health, Oncology, etc.) to improve the quality and affordability through improvements in appropriateness and effectiveness. Network Market Consultants meet with provider stakeholders and engage them in discussions ands provide clinical reports for Medicare Advantage members. In this role you will be expected to:

- Spend 80% of your time in the field: meet with provider stakeholders (office management, physicians, etc.) to provide patient clinical reports and discuss Optum's initiatives in early intervention, disease management, reimbursement and cost-savings initiatives
Anticipate customer needs and proactively develop solutions to meet them.
- Serve as a key resource on complex and/or critical issues.
- Solve complex problems and develop innovative solutions.
- Perform complex conceptual analyses.
- Review work performed by others and provide recommendations for improvement.
- Forecast and plan resource requirements.
- Authorize deviations from standards.
- May lead functional or segment teams or projects.
- Provide explanations and information to others on the most complex issues.
- Motivate and inspire other team members.
OptumInsight Clinical Performance Solutions Market Consultant

Ingenix is now OptumInsight, part of Optum a leading health services business.

OptumInsight is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

If you get excited about the life transforming potential of bringing health care information to the right place, at the right time, to support crucial decisions, welcome to OptumInsight.

We're one of the largest and fastest growing health information companies and the only organization in our industry with the information, technology and consulting expertise to solve the most significant challenges in health and human services. As a vital member of the UnitedHealth Group family, we serve customers in every segment of the health care field. This includes government agencies, pharmaceutical companies, hospitals and health delivery networks, insurance providers and, of course, the diverse business divisions of UnitedHealth Group.

Job Description
-Functioning independently, travel across the territory to meet with providers to discuss Ingenix tools and programs focused on improving the quality of care for Medicare Advantage Members.
-Utilizing data analysis, identify and target providers who would benefit from our Medicare Risk Adjustment training and documentation/coding resources.
-Educate providers on how to improve their Risk Adjustment Factor (RAF) scores, which measure their patients' health status.
-Reach out to physicians, medical groups, IPAs and hospitals, to build positive, long-term, consultative relationships.
-Develop comprehensive, provider-specific plans for accurate reporting of chronic conditions.
-Train providers on our Risk Adjustment programs and tools, and work toward the adoption of these programs in to their practices.
-Collaborate with doctors, coders, facility staff and a variety of internal and external personnel on a wide scope of Risk Adjustment education efforts.

Bring your talent to an industry leader with the information, technology, and consulting expertise to help transform health and human services. No matter what your role, you'll be empowered to ask more questions, develop better solutions and help make the health care system greater than ever.

Skills / Requirements

Requirements:
- Undergraduate degree a plus
- One year or more of negotiations, consultative sales or relationship management experience (health-care related a plus). Backgrounds in pharmacy, medical device or healthcare services are highly desireable.
- Experience in claims processing, provider data maintenance, contracting, or contract loading a plus.
- Quick study who can learn clinical facility/ancillary contract reimbursement methodologies.
- Excellent communication skills required including ability to communicate effectively with various levels of leadership
- Advanced proficiency in MS Office (Excel, Access and PowerPoint).
- Ability to travel within the region (day trips) 75% of the time

Preferred Skills:
- Project Management experience
OptumInsight is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

OptumInsight is one of the largest and fastest growing health information companies. We specialize in improving the performance of the health system by providing analytics, technology and consulting services that enable better decisions and results. We integrate workflow solutions that deliver data in real-time, and create actionable insights - processing health information that relates directly to and affects one in four patients in the U.S, one in every three Medicaid dollars and one in every five emergency room visits. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

What can YOU do with the right information? At OptumInsight, the possibilities and the impact are limitless. No matter what your role is at OptumInsight, you'll be empowered to ask more questions, develop better solutions and help make the health care system greater than ever. It's always fresh. It's always exciting. And it's never been more important.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.