Network Performance Advanced Practice Clinician - Albuquerque, NM

Company: UnitedHealth Group
Location: Albuquerque
Posted on: January 16, 2022

Job Description:

Optum New Mexico is seeking aNetwork Performance Advanced Practice Clinicianto join our Primary Care team as they care for our patient population in beautiful Albuquerque, NM. At Optum, we are transforming healthcare nationally while providing Physician-led care locally.Position Highlights

• Strategic leadership over the Independent Practice Affiliate Program in New Mexico
• Working on best practices, policies, telehealth and novel approaches for risk adjustment programs, quality and affordability
• Apply understanding of patient care quality metrics to enhance clinical outcomes (e.g., HEDIS, pharmacy, survey, and disease-based metrics)) in order to drive/achieve quality outcomes for Optum NMs Affiliate Program
• Lead efforts for RAF/HEDIS/STARS education to improve metrics and outcomes for the Affiliate Program
• Effectively engaging and bringing understanding to our external constituents such as physicians, medical and specialty societies, hospitals and hospital associations, and state regulators
• Identifying affordability opportunities through participation in local medical expense committees or market reviews
• Provide assistance in appeals review where appropriate
• Supporting all clinical quality initiatives and peer review processesWhat makes an Optum organization different?
  • Practice at the peak of their license
  • We recognize that if you want to provide good care and do it well, you cant do it alone -this is the foundation of the team-based care model
  • The culture is one of clinical innovation and transformation
  • We are a top performer of the Quadruple Aim initiative in New Mexico
  • We are influencing change on a national scale while still maintaining the culture and community or our local organizationsCompensation & Benefits Highlights
    • Med/Den/Vis, STD, LTD, United Health stock options
    • Continuing Medical Education allowance with time off
    • Robust Relocation program
    • Professional Liability Insurance
    • Excellent PTO package
    • Generous retirement program including employer funded contributions (401K)Optum New MexicoWe are happy to call Albuquerque, New Mexico home. With the tail of the Rockies at our doorstep, we have world-class hiking, biking and skiing at our fingertips. Coupled with amazing scenery, a diverse culture, remarkable food and a world renowned art scene, its no wonder were the Secret of the Southwest!Required Qualifications:
      • 5+years ofexperience as a practicing clinician preferably in a medical group
      • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliancePreferred Qualifications:
        • 2+years ofexperience at senior leadership level in medical group or network Experience in both fee-for-service and managed care operations
        • Experience and knowledge of Medicare Advantage programs (STARS, RAF, HEDIS, CHAPS/HOS etc.)
        • Experience with identifying Medicare risk adjustment and presenting findings to client/cliniciansKnowledge, Skills, Abilities:
          • Thorough understanding of medical group business models and clinical processes.
          • Ability to strategically lead regionally to ensure accurate diagnostic codes in order to maximize risk adjustment (RAF)
          • Experience with identifying Medicare risk adjustment and presenting findings to client/clinicians; Working knowledge of managed care and value based medicineTo protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.The Optum Story:At Optum, weve found that putting clinicians at the center of care is the best way to improve lives. Our physician-led organization is one of the most dynamic and progressive health care organizations in the world, serving over 17 million people through more than 45,000 aligned physicians and 9,000 advanced practice clinicians. You will find our team working in local clinics, surgery centers and urgent care centers, within care models focused on managing risk, higher quality outcomes and driving change through collaboration and innovation. Learn more about our journey at www.workatoptum.com.Diversity creates a healthier atmosphere: OptumCare and its affiliated medical practices are 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 and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.Job Keywords: Network Performance Advanced Practice Clinician,Albuquerque, NM, New Mexico

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