Clinical Practice Consultant - Advanced Medical Home - Telecommute in Asheville, NC

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)This position is responsible for strategically developing and managing clinically oriented provider and community-based partnerships in order to meet requirements of the Advanced Medical Home (AMH) program based on state specific guidelines. This role will be responsible for monitoring and providing ongoing oversight of the: AMH Tier 3 program requirements of provider practices and AMH quality improvement support activities with all AMH providers. This role will work in concert with the Local Health Department (LHD) Clinical Practice Consultants.The Clinical Practice Consultant will work closely with the Health Plan Clinical Leadership to coordinate an interdisciplinary approach to increase provider and program performance. This position will guide practices in achieving AMH quality improvement support activities and AMH Tier 3 program requirements through: oversight, performance monitoring and support; relationship management & engagement; education; and quality improvement. This position is accountable for driving practice progress toward desired transformational change and performance improvement, while meeting AMH program expectations outlined by the state. Position reports to the AMH Transformation Director.The Clinical Practice Consultant will be assigned to a specified Medicaid region within North Carolina. This is a work from home / telecommute position when not in the field but may require travel to State sponsored meetings and to the Greensboro or Raleigh office.The Advanced Medical Home program was developed by NC DHHS as the primary vehicle for delivering care management as the state transitions to Medicaid managed care and includes Tier 1, Tier 2 and Tier 3 providers. The AMH program builds on the Carolina ACCESS program. This position will focus on all AMH Tiers.If you are located in Asheville, NC, you will have the flexibility to telecommute as you take on some tough challenges.Primary Responsibilities:Drives execution of clinical practice transformation by overseeing timely and successful deployment of AMH program

Provide oversight and performance evaluation through continuous monitoring and analysis of AMH Program and Quality Program requirements and development of strategies based on performance analysis

Utilize monitoring, trending and performance improvement strategies to review progress of AMH providers, including specific Tier 3 requirements as defined by the State, and ensure the practice is accountable for successful implementation

Provide ongoing support and develop recommended actions and best practices to assist the practice in achieving contractual requirements

Regularly facilitate efficient, effective meetings with the practice to monitor, present, and discuss progress towards program requirements

Build and effectively maintain relationships with the practice leadership and key clinical influencers actively involved in practice transformation through strategic partnerships

Facilitates and participates in multi-disciplinary Joint Operational Committee meetings with external care management partners

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)

Consult and partner with internal UHC matrix partners and the practice to identify organizational and structural challenges hindering achievement of desired program outcomes

Cross-collaborate on any identified or ongoing practice needs that require the involvement of a subject matter expert

Provide education to promote quality and cost-effective outcomes around, but not limited to: Quality program and metrics, AMH Tier 3 program requirements – including Tier 3 progression, 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 improve practice performance while assessing trends in quality measures and identifying opportunities for quality improvement (e.g. AMH quality measures; value-based payment, access & availability, healthy opportunity and opioid strategies; EPSDT policies; and behavioral health integration)

Uses a systematic approach to identify practice needs and opportunities, 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

Support development, deployment and monitoring of State mandated performance improvement projects and other specific projects based on needs

Document provider outreach and work in a shared customer relationship management system, utilize to inform UHC internal staff connections and to collaborate on mutual providers and identified intersection points

Understand UHC and Optum provider-facing programs and processes to promote effective communication and collaboration

Participates, coordinates, and/or represents the Health Plan at community-based organization events, clinic days, health department meetings, and other outreach events as assigned

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 in healthcare related field or business combined with two years of equivalent work experience

5+ years clinical experience working with primary care practices, providing provider and liason support

3+ years experience working with population health, patient centered medical homes (PCMH) and/or practice transformation efforts

2+ years of quality improvement experience with responsibilities in the following areas rapid cycle change, 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 in Medicaid and/or Medicare or the managed care industry

Experience in Health care and/or insurance industry experience, including regulatory and compliance

Intermediate experience in software applications skills that include, Microsoft Word, Excel, PowerPoint

Comfortable with 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

This role requires travel to locally up to 75% of the time and may require travel up to 2 hours away from your residence on occasion

If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:CPHQ or CCM

Graduate degree

Knowledge of one or more of: clinical standards of care, HEDIS, NCQA PCMH, and governing and regulatory agency requirements

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place 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 Practice Consultant, Clinical Practice, Advanced Medical Home, Medical Home, Healthcare, Health Care, Primary Care, PCMH, Patient Centered Medical Homes, Population Health, Quality Improvement, Medicaid, Medicare, Managed Care, Insurance, Telecommute, Telecommuting, Telecommuter, Work From Home, Remote, Raleigh, Asheville, NC, North Carolina, NC