Talent.com
Account Manager of Provider Groups - Remote

Account Manager of Provider Groups - Remote

UnitedHealth GroupBolivar, MO, US
30+ days ago
Job type
  • Full-time
  • Remote
Job description

Caring. Connecting. Growing Together.

The Account Manager has geographic responsibility for the quality and economic performance of the physician practice with the goal of developing a high performing provider network within the State of Kansas and Missouri. This includes analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning. The Account Manager will develop and sustain a strong day-to-day relationship with stakeholders, the physician and office staff to effectively implement the business solutions developed by the Client Services leadership team.

The Account Manager is accountable for overall performance and profitability for their assigned groups as well as ownership and oversight to provide redirection as appropriate and approved. The responsibilities of this position include capabilities in the following areas : strategic planning and analysis; understanding of HEDIS, Star ratings, accurate documentation, and coding; advanced communication skills; and the ability to develop clear action plans and drive process.

If you are located in El Dorado Springs, MO, you will have the flexibility to work remotely

  • as you take on some tough challenges.

Essential Job Functions :

  • Educate providers to ensure they have the tools needed to meet quality, coding and documentation, and total medical cost goals per business development plans
  • Develops strategies and create action plans that align provider pools and groups with company initiatives, goals, quality outcomes, program incentives, and patient care best practices
  • Drive processes and improvement initiatives that directly impact revenue, HEDIS / STAR measures and quality metrics, coding and documentation process and educational improvements
  • Conduct new provider orientations and ongoing education to provider and their staff on healthcare delivery products, health plan partnerships, processes, and tools
  • Use and analyze data to identify trends, patterns and opportunities for the business and clients, and collaborating and / or participating in discussions with colleagues and business partners to identify potential root cause of issues
  • Conduct provider meetings to share and discuss reporting data and analysis, issue resolution needs, implement escalation processes for discrepancies, and manages or ensures appropriate scheduling, agenda, and materials
  • Collaborates with internal clinical services teams, alongside operational leaders' leaders, to monitor utilization trends to assist with developing strategic plans to improve performance
  • Assists provider groups with investigating standard and non-standard requests and problems, to include claims and member support services
  • Maintains effective support services by collaborating effectively with the medical director, operations, and cross functional teams, and other departments
  • Demonstrate understanding of providers' business goals and strategies to facilitate the analysis and resolution of their issues
  • Performs all other related duties as assigned
  • Primary Responsibilities :

  • Solid analytical skills required to support, compile, and report key information
  • Drive processes that directly impact revenue, HEDIS / STAR measures and quality metrics, and total cost of care, as appropriate
  • Use data to identify trends, patterns and opportunities for the business and clients. Develop business strategies in line with company strategic initiatives
  • Engage provider staff and providers in analysis and evaluation of functional models and process improvements; identify dependencies and priorities
  • Evaluate and drive processes, provider relationships and implementation plans
  • Produce, publish, and distribute scheduled and ad-hoc client and operational reports relating to the performance of related metrics and goals
  • Collaborate with internal leaders to foster teamwork and build consistency throughout the market
  • Serves as a liaison to the health plan and all customers
  • Requires solid presentation skills, problem solving and ability to manage conflict and identify resolutions quickly
  • Have the ability to communicate well with physicians, staff, and internal departments
  • 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 :

  • 4+ years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor's degree
  • 3+ years of experience in a related medical field or health plan setting (network management, contracting and / or recruitment, or provider relations)
  • Solid working knowledge of Medicare health care operations including HEDIS, CMS reimbursement models, and Medicare Advantage
  • Understanding of IPAs, Clinically Integrated Networks, Medicare Shared Savings Programs, capitation / value-based contracting, and narrow networks
  • Proficiency in Microsoft Word, Excel, and PowerPoint
  • Knowledge of state and federal laws relating to Medicare
  • Valid driver's license and access to reliable transportation
  • Ability to travel 25% of the time
  • Preferred Qualifications :

  • Demonstrated ability to function as a mentor to others
  • Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

    At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. 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.

    OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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

    Create a job alert for this search

    Account Manager Remote • Bolivar, MO, US

    Related jobs
    Account Manager

    Account Manager

    CircadiaSpringfield, MO, USA
    Full-time
    Quick Apply
    Circadia (formerly Scott Rice Office Works) is one of the premier commercial furnishing providers in the country, creating spaces that are engaging, inspiring, and perfectly tailored to our clients...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Physical Therapist

    Travel Physical Therapist

    Medical Solutions AlliedBuffalo, MO, US
    Full-time
    Medical Solutions Allied is seeking a travel Physical Therapist for a travel job in Buffalo, Missouri.Job Description & Requirements. We’re seeking talented healthcare professionals whose ...Show moreLast updated: 4 days ago
    • Promoted
    Telemedicine Physician

    Telemedicine Physician

    QuickMDBuffalo, MO, US
    Full-time
    QuickMD is a leading telemedicine provider, delivering high-quality virtual care across 44 states.Since our founding in 2019, we have helped more than 100,000 patients access essential medical trea...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Heartland Open House Hiring Event October 13-17

    Heartland Open House Hiring Event October 13-17

    Heartland HospiceOsceola, MO, United States
    Full-time +1
    Discover Your Next Role in Hospice Care.Hospice RNs, LPNs, and CNAs – Join Our Team!.Gentiva Hospice invites you to our.We are seeking passionate, committed professionals who want to make a differe...Show moreLast updated: 6 hours ago
    • Promoted
    Account Sales Representative

    Account Sales Representative

    TradeJobsWorkforce65622 Buffalo, MO, US
    Full-time
    Account Sales Representative Job Duties : Identifies market potential by qualifying accounts.Initiates sales process by scheduling appointments; making initial presenta...Show moreLast updated: 30+ days ago
    • Promoted
    Remote Client Relations Coordinator

    Remote Client Relations Coordinator

    TradeJobsWorkforce65622 Buffalo, MO, US
    Remote
    Full-time
    As a Remote Client Relations Coordinator, you will be responsible for supporting customers and handling inquiries from the comfort of your home, including : respond to customer inquiries via phone, ...Show moreLast updated: 30+ days ago
    Account Manager- LTL / Freight

    Account Manager- LTL / Freight

    FedExSpringfield, Missouri, US
    Full-time
    As a member of a sales team, the sales professional is responsible for new business development, account implementation and maintaining and deepening customer relationships within a defined geograp...Show moreLast updated: 30+ days ago
    Remote Sales Agent

    Remote Sales Agent

    GIA Legacy PlanningSpringfield, Missouri, US
    Remote
    Full-time +1
    Quick Apply
    Remote Position / Work from Home.We specialize in providing personalized insurance solutions to protect families and businesses. Our culture is built on integrity, mentorship, and professional growth....Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse RN - Long-Term Care - $1,535 to $1,835 per week in Iowa

    Travel Nurse RN - Long-Term Care - $1,535 to $1,835 per week in Iowa

    TravelNurseSourceAll Cities, IA, US
    Full-time
    TravelNurseSource is working with Wayward Medical Staffing to find a qualified Long-Term Care RN in Iowa!.Wayward Medical : Because You’re More Than a Chart Number. At Wayward Medical Staffing, we’re...Show moreLast updated: 1 day ago
    • Promoted
    Travel Physical Therapist (PT) - $1,820 to $3,000 per week in Buffalo, MO

    Travel Physical Therapist (PT) - $1,820 to $3,000 per week in Buffalo, MO

    AlliedTravelCareersBuffalo, MO, US
    Full-time
    AlliedTravelCareers is working with CompHealth to find a qualified Physical Therapist (PT) in Buffalo, Missouri, 65622!.CompHealth exists to make the locums process easier.Not only will we search f...Show moreLast updated: 30+ days ago
    Commercial Lines Account Manager (Fully Remote)

    Commercial Lines Account Manager (Fully Remote)

    Insurance Office of AmericaSpringfield, MO, US
    Full-time
    Title : Account Manager - Commercial Lines.General, Construction (required experience).Please note : If this position is posted as either fully remote and / or hybrid, in accordance with company policy...Show moreLast updated: 26 days ago
    • Promoted
    Account Manager

    Account Manager

    Republic ServicesSpringfield, MO, US
    Permanent
    The Account Manager is responsible for proactively maintaining and retaining relationships with existing customers for permanent commercial and industrial waste services in an assigned territory.Ad...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse - RN - ICU - Intensive Care Unit - $1994.94 / Week

    Travel Nurse - RN - ICU - Intensive Care Unit - $1994.94 / Week

    Medical SolutionsBolivar, MO, US
    Full-time
    Medical Solutions is seeking an experienced Intensive Care Unit Registered Nurse for an exciting Travel Nursing job in Bolivar, MO. Shift : 3x12 hr nights Start Date : ASAP Duration : 13 weeks Pay : $19...Show moreLast updated: 5 days ago
    • Promoted
    Travel Physical Therapist (PT) - $2,405 per week in Buffalo, MO

    Travel Physical Therapist (PT) - $2,405 per week in Buffalo, MO

    AlliedTravelCareersBuffalo, MO, US
    Full-time
    AlliedTravelCareers is working with Advantis Medical Staffing to find a qualified Physical Therapist (PT) in Buffalo, Missouri, 65622!. Advantis Medical, the #1 rated travel nurse agency, is current...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Registered Nurse - Long-Term Care - $1,535 to $1,835 per week in Iowa

    Travel Registered Nurse - Long-Term Care - $1,535 to $1,835 per week in Iowa

    TravelNurseSourceAll Cities, IA, US
    Full-time
    TravelNurseSource is working with Wayward Medical Staffing to find a qualified Long-Term Care RN in Iowa!.Wayward Medical : Because You’re More Than a Chart Number. At Wayward Medical Staffing, we’re...Show moreLast updated: 1 day ago
    • Promoted
    Health System Account Field Liaison

    Health System Account Field Liaison

    McKessonSpringfield, MO, US
    Full-time
    McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare.We are known for delivering insights, products, and services that make quality care more accessibl...Show moreLast updated: 30+ days ago
    Business Account Manager (B2B Sales)

    Business Account Manager (B2B Sales)

    Leadsphere Solutions, Inc.Springfield, MO, US
    Full-time
    Quick Apply
    Springfield, is looking for an entry level Business Account Manager to join our team.This Business Account Manager role is an exceptional entry-level opportunity for those ready to gain hands-on ex...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse - RN - ICU - Intensive Care Unit - $1994.94 / Week - Hiring Now

    Travel Nurse - RN - ICU - Intensive Care Unit - $1994.94 / Week - Hiring Now

    Medical SolutionsBolivar, MO, US
    Full-time
    Medical Solutions is seeking an experienced Intensive Care Unit Registered Nurse for an exciting Travel Nursing job in Bolivar, MO. Shift : 3x12 hr nights Start Date : ASAP Duration : 13 weeks Pay : $19...Show moreLast updated: 5 days ago
    • Promoted
    Travel Physical Therapist (PT) - $2,361 per week in Buffalo, MO

    Travel Physical Therapist (PT) - $2,361 per week in Buffalo, MO

    AlliedTravelCareersBuffalo, MO, US
    Full-time
    AlliedTravelCareers is working with Medical Solutions to find a qualified Physical Therapist (PT) in Buffalo, Missouri, 65622!. A facility in Buffalo, MO is seeking its next amazing PT (Physical The...Show moreLast updated: 4 days ago
    • Promoted
    Travel Physical Therapist (PT) - $2,120 per week in Buffalo, MO

    Travel Physical Therapist (PT) - $2,120 per week in Buffalo, MO

    AlliedTravelCareersBuffalo, MO, US
    Full-time
    AlliedTravelCareers is working with Skyline Med Staff to find a qualified Physical Therapist (PT) in Buffalo, Missouri, 65622!. Join the Top- Rated Travel Healthcare Team! Skyline Med Staff was nam...Show moreLast updated: 30+ days ago