For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

Optum’s Pacific West region is redefining health care with a focus on health equity, affordability, quality, and convenience. From California, to Oregon and Washington, we are focused on helping more than 2.5 million patients live healthier lives and helping the health system work better for everyone. At Optum Pacific West, we care. We care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions.

Position in this function is responsible for the operations of the provider network(s) in assigned region, and is the direct interface between Optum and the affiliate physician network. This position provides continuous education, support, training and troubleshooting to physicians and their staff. Serve as an interface between the central departments and the Independent Physician Association (IPA) network.

Primary Responsibilities:

• Service Excellence:
  • Serves as single-point-of-contact to the physician network and is an accountable owner, responsive to physician needs. Knowledgeable about incentive programs, contract reimbursement, practice and network profitability, ACOs and other Optum initiatives, as applicable
  • Responds timely (within one business day) to provider issues, works with other groups/central departments to resolve issues and updates providers and office staff regularly through to resolution
  • Is proactive in identifying issues and determining root cause so that they can be resolved timely and completely. Escalates certain issues as appropriate to leadership
  • Build collaborative relationships with IPA physicians and their office staff
• Presence & Visibility:
  • Adheres to scheduled cadence for touchpoints and ensures that agreed upon agenda is followed and action items are documented and tracked
  • Attends external office staff meetings and community/town hall meetings, as required, and completes any action items that may arise from those meetings
  • Maintains awareness of providers interested in further engaging with Optum on new business opportunities (contracts and business combinations), and on shifting market/competitive dynamics that would impact the IPA
• Provider Training and Adherence:
  • Onboard new physicians and their office staff
  • Works with office staff to develop and maintain adherence to Optum processes
  • Be available to answer questions and train staff on various portals and other resources available
  • Educates physicians on incentive programs and the potential earnings
  • Ensures that the physicians and their office staff receives and understands the various communications that are issued. Evaluates training needs for physicians and offices, and ensures the timely delivery of needed training
• Clinical Quality and Patient Satisfaction:
  • Regularly educates offices on their current performance on key performance indicators (KPIs)
  • Monitors performance of assigned PCPs, identifies low performing PCPs and works with IPA leadership to develop action plan for specific metrics needing improvement. Works with office to effectuate action plan and monitors progress. Intervenes and escalate issues as appropriate
  • Engages, seeks assistance and intervention from IPA Medical Director and/or Quality Manager
  • Knowledgeable about the various quality measures and improvement programs, and educates the offices on how to improve performance
  • Supports and helps practices to earn the maximum bonus possible related to Clinical Quality and Patient Satisfaction measures
  • Engages IPA physicians and staff in enhancing quality and patient satisfaction
• Growth and Retention:
  • Works collaboratively with offices, Optum marketing team and brokers to drive membership growth and retention
  • Monitors and identifies trends on membership decline and escalates to leadership as appropriate
  • Addresses PCP specific issues identified as part of dis-enrolled member calls
  • Assists with OEP efforts by working with offices, marketing team, and brokers; attends OEP events with marketing to strengthen relationships with PCPs
    

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:

• Bachelor’s degree or demonstrated equivalent experience
• 3+ years of customer service experience
• Managed Care experience
• Intermediate level of experience with Microsoft Suite
• Ability to travel to locations in region
  

Preferred Qualifications:

• Master's degree or demonstrated equivalent experience
• Experience in a health plan, managed care organization, medical group physician office or IPA setting
  

Careers at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.(sm)

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare’s support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

California Residents Only: The salary range for California residents is $67,800 to $133,100. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.