Clinical Practice Consultant, Minneapolis, MN - Telecommute

UnitedHealth Group Remote
minneapolis telecommute health cpc team data behavioral health driving management healthcare performance improvement health equity drive

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

As a part of a national team focused on making the healthcare system work better for everyone, the Clinical Practice Consultant (CPC) is responsible for driving transformation efforts of interdisciplinary practices which are under the oversite purview of UnitedHealthcare's (UHC) Community Integrated Care team. The CPC will facilitate practice transformation through performance improvement initiatives to ensure that care management needs of our most vulnerable members are met. In this way, UHC enhances health equity, creates shared care planning opportunities, fosters collaborative relationships and improves the experience of the healthcare professionals with which we partner. This CPC will focus primarily on supporting Minnesota's Health Care Home (HCH) organizations, though they may also be called to drive transformation efforts within large PCP practices, Behavioral Health Agencies, Federally Qualified Health Centers (FQHC) and Rural Health Centers (RHC) not already associated with an HCH as well.

Minnesota's Department of Health developed Health Care Homes to foster improved chronic disease management within the state through enhancing the Patient Centered Medical Home (PCMH) model. The CPC is accountable for driving practice progress toward desired transformational change and performance improvement, while overseeing care management for our members as well as health equity goals set with the practice. The CPC is responsible to act as the liaison between the Health Care Home and the C&S Plan Clinical Team

The goals of the Health Care Home model are to:

  • Continue building a strong primary care foundation to ensure all Minnesotans have the opportunity to receive team-based, coordinated, patient-centered care.
  • Increase care coordination and collaboration between primary care clinicians and community resources to support whole person care and facilitate the broader goals of improving population health and health equity.
  • Improve the quality, experience, and value of care.

As the single point of clinical contact for a practice, the CPC will be responsible for communicating progress towards achievement of targeted goals to Senior Leadership both within UnitedHealthcare and at the practice.

If you are within commutable distance from Minneapolis, MN, you'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Accountable for support role in successful deployment of UHC's Clinical Support program at the market and practice levels, including but not limited to, introducing as well as educating practices on the value/use of reporting tools, clinical integration, patient registries and delivery of reports via UHC's Technology Portals
  • Build and effectively maintain relationship with the practice leadership and key clinical influencers actively involved in practice transformation
  • Regularly facilitate efficient, effective practice improvement meetings with the practice to monitor, present, and discuss progress on the transformation action plan and achievement in milestones
  • Develop strategies; based on performance analysis, for improvement that includes specific outcomes and metrics to monitor progress to a goal and make recommendations for improvement
  • Responsible for assessing providers for primary and behavioral integration levels within the market and resulting transformation efforts
  • Design practice transformation action plans and implement appropriate performance improvement initiatives designed to assist the practice in achieving contractually required transformation milestones
  • Monitor and review the progress of the practice in milestone achievement and insure the practice is accountable for successful completion
  • Where outcomes are below goal the CPC will identify outlier member files for focused action plans
  • Audit of Health Care Home assessments and member care plans to ensure compliance with regulatory requirements
  • Use data to analyze key cost, utilization and quality data and interpret results to assess the performance of the practice
  • Use data to analyze trends and work with stakeholders to agree on and implement proactive strategies to address issues, and measure impact using a Plan-Do-Study-Act (PDSA) rapid cycle improvement approach; including external practice data
  • Educate & Deploy technology tools to support Practice Transformation
  • Build and effectively maintain relationships with team members in the UHC Clinical organization as well Medical Directors, local Network leads, Health Care Economic Analysts and Clinical Analysts in support of the program
  • Consult and partner with internal UHC matrix partners and the practice to identify organizational and structural challenges hindering achievement of desired program outcomes
  • Collaborate with UnitedHealthcare teams including the practice Care Coordinators, quality management teams, hospital clinical teams, behavioral health teams to support whole person care for our members with practices and hospitals
  • Assist and support department leaders in summarizing and disseminating experience - related learning's by way of team updates, written reports / articles, and / or presentations as called for by directors
  • Ensure all required member documents as indicated in the Community and State UnitedHealthcare contract for Health Home programs

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:

  • Bachelor's degree or equivalent relevant experience
  • 4 years of experience with improving clinical quality, health care analytics, utilization review, or driving clinical transformation initiatives with population health programs in a Managed Care setting
  • Experience in interpreting and utilizing clinical data analytics, outcomes measurement in healthcare and use of that data to drive change
  • Experience working with and collaborating successfully with senior level leadership
  • Experience leading groups and strong presentation skills
  • Solid Microsoft Office Skills with Word, Excel, Outlook and PowerPoint
  • Access to reliable transportation that will enable you to travel physician practice sites within a designated area (Requires valid driver's license)
  • Willingness to travel up to 25% for face-to-face meetings throughout the Minneapolis, MN area
  • Full COVID-19 vaccination is an essential requirement of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance

Preferred Qualifications:

  • Master's Degree in nursing or a behavioral health specialty
  • Active, unrestricted RN license in Minnesota or Licensed Behavioral Health Specialist (e.g., social worker, marriage and family therapist, behavioral health counselor)
  • Certified Case Manager (CCM)
  • Experience implementing Clinical Practice Transformation initiatives designed to help provider or hospital groups achieve large-scale health transformation goals
  • Community Safety Net Provider Systems of Care experience
  • Solid Relationship building skills with internal and practice teams to drive goal alignment

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, 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

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)

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