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　　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 contracted Independent Physician Association (IPA) network.

　　Primary Responsibilities:

　　Service Excellence:

　　Serves as single-point-of-contact to the IPA 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

　　IPA Provider Training and Adherence:

　　Onboard new IPA 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:

　　3+ years of health care/managed care experience

　　3+ years of provider relations and/or provider network experience

　　1+ years experience with Medicare and Medicaid regulations

　　Intermediate level of proficiency in claims processing and issue resolution

　　Proficiency with MS Word, Excel, PowerPoint and Access

　　70% local travel to visit provider offices within San Fernando Valley( mileage reimbursement provided)

　　Candidate based in San Fernando Valley

　　Valid Driver license

　　Preferred Qualifications:

　　Certified Professional Coder (CPC) and/or Certified Risk Adjustment Coder (CRC)

　　Experience in managed care working with network and provider relations and engagement

　　Consulting experience

　　Medical/clinical background

　　Knowledge of electronic medical record systems

　　Knowledge of the Medicare market

　　Financial analytical background within Medicare Advantage plans (Risk Adjustment/STARS Calculation models)

　　California Residents Only: The salary range for California residents is $70,200 to $137,800 annually. 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.