Kansas Works Veterans Jobs

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The Provider Consultant Liaison (PC) is responsible for the ongoing clinical management and quality oversight of Optum’s value-based programs and special provider initiatives. The PC will be responsible for developing relationships with behavioral health providers and facilities and driving a quality improvement process to improve clinical outcomes, increase efficiency, and reduce overall benefit expense. The PC will monitor provider performance and compliance with contractual obligations, provide tools to assist with performance and compliance, and is accountable for driving provider performance improvement. As the single point of clinical contact for a provider, the PC will be responsible for communicating progress towards achievement of targeted goals to Senior Leadership both within Optum and the participating provider.

The PC must demonstrate strong clinical and analytic skills, strong oral and written communication skills and must be comfortable working closely with senior leaders at high volume facilities/groups and/or providers. This PC will work closely with Care Advocacy Operations, Affordability, Network Management teams and other relevant departments to affect desired outcomes with the participating provider as it relates to treatment for our membership.

If you are located in Kansas, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Build and effectively maintain relationship with the provider leadership and key clinical staff

• Monitoring provider performance on program metrics, quality outcomes and adherence to contract requirements

• Regularly facilitate oversight meetings with the provider to present, and discuss performance

• Conduct provider program audits and provide feedback and results

• Identify performance improvement opportunities through analysis of data and provider feedback

• Communicate with providers to initiate interventions focused on improvement of clinical outcomes and efficiency, as well as compliance with contractual obligations

• Initiate and monitor Quality Improvement Plans to drive performance

• Modify interventions as appropriate

• Support those high performing providers such that performance remains at a high level

• Provide clinical and care coordination support

• Deliver education and training

• Interface with other Optum departments including Care Advocacy, Affordability, Clinical Network Services, Program and Network Integrity, and Quality Improvement

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:

• Independently licensed Master's degree-level clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling, Licensed Ph.D./Psy.D. level Psychologist, or Registered Nurse with a BSN or equivalent degree in a behavioral health-related area

• Licenses must be active and unrestricted in Kansas

• Experience in interpreting and utilizing clinical data, outcome measurements in healthcare and use of that data to drive change

• Experience identifying performance improvement opportunities and influencing quality metrics

• Demonstrated experience leading groups and strong presentation skills

• Proven solid relationship building and influencing skills

• Proven solid written and verbal communication skills

• Proven excellent time management and prioritization skills

• Proven solid computer skills at the intermediate level, proficiency with MS Office

• Demonstrated ability to balance contractual and clinical considerations

Preferred Qualifications:

• 3+ years of Managed Care and/or Utilization Review experience in a Managed Care setting is highly preferred with experience working with facility/group-based care advocacy.

• 3+ years direct behavioral health clinical experience

• Experience with Value-Based Programs

• Working knowledge of Public Sector benefit plans

• Working knowledge of claims processes and billing codes

*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.

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