Job Information
UnitedHealth Group Care Value Optimization Consultant - Overland Park, KS in Overland Park, Kansas
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 to start Caring. Connecting. Growing together.
The Care Value and Optimization Consultant (CVO) Consultant researches and investigates critical business problems through quantitative analyses of revenue, utilization metrics, healthcare costs, membership trends, and quality and risk adjustment data. The CVO Consultant provides management with statistical findings and conclusions and partners with stakeholders to identify areas of opportunity to improve the financial performance of clinics and risk pools. CVO Consultant also develop recommendations and strategies and communicates findings to leadership and operations teams to help implement corrective action plans.
Primary Responsibilities:
Demonstrate understanding of a provider’s business goals, contracting, performance metrics/scorecard, industry trends, and business model
Coaches and provides the translation of financial data to guide action
Assist with contracted and affiliated efforts
Market contracting strategy
Assist Physician Business Managers (PBMs) with financial education, meeting presentations, and identifying areas of opportunities
Corrective action plan for pools
Analysis of yearly contracted pool structure
Pool movement and restructuring impact
Compliance of pool criteria and structure
Monitors and reviews metric performance for Hospital and Specialty Joint Operating Committees (JOC)
Conduct financial and (Health Care Economics) HCE training for new providers and staff
Partner with market dyads on market-wide initiatives
Act as SME over market financials and support leadership on strategic projects and decisions
Develop tracking metrics and perform analysis of special projects
Monthly or weekly report card/analysis packet
Support market meetings: Strategic meetings, Contracted Pool meetings, and Monthly Market Success meetings (MSM) and/or Grand Rounds (GR)
Performs all other related duties as assigned
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 general healthcare data analysis experience
2+ years of experience in a reporting and analytical role
Experience working directly with clinicians
Understanding of the complexity of Member healthcare, claims
Knowledge of Managed Care and Medicare programs
Ability to communicate and facilitate strategic meetings with groups of all sizes
Solid verbal and written communication skills
Ability to work independently, use good judgment and decision making process
Ability to conduct performance evaluation to identify performance measures or indicators and the actions needed to improve or correct performance, relative to the goals
Proficient in MS Excel and/or equivalent data capture/reporting tools
Ability to travel up to 75% within assigned market
Preferred Qualifications:
3+ years of experience in a clinical setting
Risk Adjustment knowledge related to CMS reimbursement models
Ability to act as a mentor to others
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
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.