Clinical Practice Performance Consultant - Remote in Wilmington, NC and Surrounding Areas

About the position At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. If you reside within a reasonable commute to New Hanover County and 14 surrounding counties (Bladen, Brunswick, Columbus, Cumberland, Harnett, Hoke, Lee, Montgomery, Moore, Pender, Richmond, Robeson, Sampson, Scotland), you will have the flexibility to work remotely as you take on some tough challenges.

Responsibilities

• Provide oversight and performance evaluation through continuous monitoring and analysis of CMARC/CMHRP program requirements and development of strategies based on performance analysis
• Regularly facilitate efficient, effective meetings with the CMARC/CMHRP programs to monitor, present, and discuss progress towards program requirements
• Provide ongoing support, develop recommended actions, and best practices to assist OB providers and LHD CMARC/CMHRP Programs in achieving contractual requirements
• Build and effectively maintain relationships with OB Providers, CMARC/CMHRP programs, LHD practice leadership and key clinical influencers actively involved in practice transformation through strategic partnerships
• Serve as liaison and clinical resource using proven interpersonal and collaboration skills to foster relationships and maintain communication with multiple disciplines (e.g. Clinically Integrated Networks (CINs), internal UHC teams, external stakeholders, and other partners as appropriate)
• Collaborate with DHHS and DPH leadership for CMARC/CMHRP programs to ensure appropriate policies, processes, oversight and outcomes
• Consult and partner with internal UHC matrix partners and the practice to identify organizational and structural challenges hindering achievement of desired program performance and quality outcomes
• Provide education to promote quality and cost-effective outcomes around: pregnancy medical program (PMP), dissemination of the latest information on effective practices, and utilization of tools and resources to meet needs of the population (e.g. best practice guidelines, practice management support, population health program implementation, and/or with other appropriate resources)
• Implement basic quality improvement principles to provide technical assistance and support to LHD and OB providers while assessing trends in quality measures and identifying opportunities for quality improvement (e.g. AMH identified quality measures, pay for performance measures)
• Uses a systematic approach to identify CMARC/CMHRP program and LHD practice needs, perform data analysis, and develops actionable solutions to improve quality outcomes
• Assist practices with analyzing and interpreting data to quickly identify problems, patterns, and high-risk activities
• Facilitate discussions around different data visualization strategies, including differences in databases, and basic data sharing and management of resources
• Cross-collaborate with the quality, AMH, or provider relation teams for any identified or ongoing practice needs that require the involvement of a subject matter expert
• Facilitates and participates in Joint Operational Committee with external care management partners
• Participates, coordinates, and/or represents the Health Plan at community based organization events, clinic days, health department meetings, and other outreach events as assigned

Requirements

• 3+ years of experience working with maternity populations (OB provider or OB clinic setting) OR local health departments
• 2+ years of experience with responsibilities in the following areas: data analysis and interpretation, systems analysis, graphical display of data/information, public speaking, group leadership and facilitation, and demonstrated problem solving and critical thinking skills
• 2+ years of experience working with the Medicaid population
• 2+ years of experience in creating presentations and working with data to formally present information to physicians, administrators, other providers and community partners, engaging different types of learners in various settings (e.g. practice offices, CIN/other partner offices, community settings)
• Intermediate experience in software applications skills that include, Microsoft Word, Excel, PowerPoint
• This role requires travel to locally up to 75%25 of the time and may require travel up to 2 hours away from your residence on occasion

Nice-to-haves

• Program oversight experience
• Maternity experience in OB Provider or Clinic Setting
• Knowledge of one or more of: clinical standards of care, HEDIS, NCQA PCMH, and governing and regulatory agency requirements
• Resides in North Carolina, specifically Region 5 (which encompasses one of the 14 counties surrounding Wilmington, NC)

Benefits

• comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution