Senior Provider Relations Manager - Orange County

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

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.

Positions in this function is are responsible for the operations of the provider network(s) in the 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 office staff.

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 receive 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
  • Knowledgeable about the various quality measures and improvement programs, and educates the offices on how to improve performance
  • Supports and helps practices in Clinical Quality and Patient Satisfaction measures
  
  
  
  
• 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
  • Assists with OEP efforts by working with offices, marketing team, and brokers
  
  
  
  

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:

• 2+ years of experience in a health plan, managed care organization, medical group physician office or IPA setting
• Intermediate level of experience with Microsoft Suite
• Managed Care experience

Preferred Qualification:

• 5+ years of experience in a health plan, managed care organization, medical group physician office or IPA setting

California Residents Only: The salary range for this role is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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: 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.