Note: The job is a remote job and is open to candidates in USA. Optum is a healthcare organization that uses technology to improve health outcomes and connect people with care and resources. The Provider Enablement Consultant manages clinical oversight and quality improvement for behavioral health value-based programs, building provider relationships, monitoring performance and compliance, and driving improved clinical outcomes and efficiency.
Responsibilities
- Build and effectively maintain relationships with provider leadership and key clinical staff
- Regularly facilitate oversight meetings with providers to monitor, present, and discuss performance
- Monitor provider performance on program metrics, quality outcomes and adherence to contract requirements
- 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
- Conduct provider program audits and provide feedback and results
- Support 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
Skills
- • Active and unrestricted Master's degree-level clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling, Licensed Ph.D/Psy.D. level Psychologist, or Bachelor's level RN (licensure must be in state of residence)
- • 3+ years post-licensure direct behavioral health clinical experience
- • 1+ years of experience in a managed care setting
- • 1+ years of experience performing analysis, reporting, and data analytics within healthcare, Medicaid, and/or health & human services environment
- • Intermediate level of proficiency with Microsoft Office (Excel required)
- • Working knowledge of Public Sector benefit plans
- • Experience identifying performance improvement opportunities and influencing quality metrics
- • 3+ years of Managed Care experience
- • Ability to balance contractual and clinical considerations
- • Strong relationship building and influencing skills
- • Strong written and verbal communication skills
- • Excellent time management and prioritization skills
Benefits
- Flexibility to work remotely from anywhere within the U.S.
- Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
- Medical Plan options along with participation in a Health Spending Account or a Health Saving account
- Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage
- 401(k) Savings Plan, Employee Stock Purchase Plan
- Education Reimbursement
- Employee Discounts
- Employee Assistance Program
- Employee Referral Bonus Program
- Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
- Incentive and recognition programs
- Equity stock purchase and 401k contribution
Company Overview
Company H1B Sponsorship