1+ months

Physician Business Consultant - El Paso, TX - 923673

El Paso, TX 79901
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  • Job Code
    923673

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your lifes best work.(sm)

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The Physician Business Consultant (PBC) researches and investigates critical business problems through quantitative analyses of revenue, utilization metrics, healthcare costs, membership trends, and quality and risk adjustment data. The PBC provides management with statistical findings and conclusions and partners with stakeholders to identify areas of opportunity to improve the financial performance of clinics and risk pools. PBCs also develop recommendations and strategies and communicates findings to leadership and operations teams to help implement corrective action plans.

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Primary Responsibilities:

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  • Demonstrate understanding of a providers business goals, contracting, performance metrics / scorecard, industry trends, and WellMed business model
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  • Coach and provide the translation of financial data to guide action
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  • Assist with contracted and affiliated efforts
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  • Market contracting strategy
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  • Assist PBMs with financial education, meeting presentations, and identifying areas of opportunities
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  • Corrective action plan for pools
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  • Analysis of yearly contracted pool structure
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  • Pool movement and restructuring impact
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  • Compliance of pool criteria and structure
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  • Monitor and review metric performance for Hospital and Specialty Joint Operating Committees (JOC)
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  • Conduct financial and HCE training for new providers and staff
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  • Partner with market dyads on market-wide initiatives
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  • Act as SME over market financials and support leadership on strategic projects and decisions
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  • Develop tracking metrics and perform analysis of special projects
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  • Monthly or weekly report card / analysis packet
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  • Support market meetings: Strategic meetings, Contracted Pool meetings, and Monthly Market Success meetings (MSM) and /or Grand Rounds (GR)
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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.

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Required Qualifications:

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  • Bachelors Degree, Finance, Accounting, Business Administration, Healthcare Administration, or related field required (4 additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelors degree)
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  • 3+ years of general healthcare data analysis experience
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  • 2+ years of experience in a reporting and analytical role
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  • Understanding of the complexity of Member healthcare, claims
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  • Knowledge of Managed Care and Medicare programs
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  • Proficient in MS Excel and /or equivalent data capture / reporting tools
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  • Ability to travel up to 75% within assigned market
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  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
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Preferred Qualifications:

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  • Risk Adjustment knowledge related to CMS reimbursement models
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  • 3+ years of experience in a clinical setting
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  • Ability to act as a mentor to others
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  • Ability to communicate and facilitate strategic meetings with groups of all sizes
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  • Strong verbal and written communication skills
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  • Ability to work independently, use good judgment and decision-making process
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  • Ability to conduct performance evaluation to identify performance measures or indicators and the actions needed to improve or correct performance, relative to the goals
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Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

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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.

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

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Job Keywords: Provider relations, physician consultant, analyst, managed care, Medicare, reporting, data, El Paso, TX, Texas

Posted: 2021-04-29 Expires: 2021-06-30

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Physician Business Consultant - El Paso, TX - 923673

UnitedHealth Group
El Paso, TX 79901

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