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Value Based Program Consultant - Telecommute in MN job at UnitedHealth Group, Orlando

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Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

The Value Based Program Consultant is responsible for the ongoing clinical management and quality oversight of Optum’s value-based programs.  The Value Based Program Consultant will be responsible for developing relationships with participating behavioral health providers and facilities, and driving a quality improvement process to improve quality, improve clinical outcomes, increase efficiency and reduce overall benefit expense. The Value Based Program Consultant 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 Value Based Program Consultant will be responsible for communicating progress towards achievement of targeted goals to Senior Leadership both within Optum and the participating provider.

The Value Based Program Consultant 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 Value Based Program Consultant 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 the state of Minnesota you will have the flexibility to telecommute* as you take on some tough challenges. equires occasional (25%) travel to on-site meetings in the Twin Cities area (St. Paul/Minneapolis)

Primary Responsibilities:

  • Build and effectively maintain relationship with the provider leadership and key clinical staff
  • Regularly facilitate oversight meetings with the provider to monitor, present, and discuss performance
  • Monitoring provider performance on program metrics, quality outcomes and adherence to contract requirements
  • Conduct provider program audits and provide feedback and results
  • Identify performance improvement opportunities through analysis of operational data, clinical outcome data and utilization/claims data
  • 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
  • Monitor and report effectiveness of interventions
  • 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 OHBS 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 behavior health clinician including: LISW, LICSW, LPC, LPCC, LMFT, PsyD or, an RN with behavioral health experience
  • License must be active and unrestricted in Minnesota
  • Experience in interpreting and utilizing clinical data analytics, outcomes measurement 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
  • Solid computer skills at the intermediate level, proficiency with MS Office
  • Ability to balance contractual and clinical considerations
  • Willingness to travel approximately 25% for face to face meetings
  • 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 compliance

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 post licensure direct behavioral health clinical experience
  • Working knowledge of Public Sector benefit plans
  • Solid relationship building and influencing skills
  • Solid written and verbal communication skills
  • Excellent time management and prioritization skills 

To 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.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.


Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords:  Clinical, Clinician, Psychology, Social Work, Substance Abuse, LPC, LCSW, LMFT, RN, Registered Nurse, Behavioral Health, Mental Health, Manager, Health Homes, Medicaid, Quality Improvement, Quality, Analytics, Population Health Management, Clinical Outcomes, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote, Minneapolis, Saint Paul, MN, Minnesota


Job country: United States

City: Orlando

Category: Business Operations Specialists, All Other

Location: Orlando, FL, United States

Job posted 2022-06-04

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