OptumInsight (formerly Ingenix) is searching for a motivated, skilled Healthcare Market Consultant to join our team. As a member of the Payer & Government Health Management Solutions team within OptumInsight, you will consult with physicians throughout the counties of Northern and Central New Jersey.
This role will include, but not limited to the following counties of New Jersey: Bergen, Hudson, Middlesex, Union, Essex, Hunterdon, Mercer and Somerset.
Responsibilities include:
Functioning independently, the Market Consultant will travel throughout the counties of Northern and Central New Jersey to meet with assigned provider groups to discuss OptumInsight tools and programs focused on improving the quality of care for Medicare Advantage and Medicaid Members.
Utilizing data analysis, identify and target providers who will benefit from our Medicare Risk Adjustment and Quality training and documentation/coding resources.
Utilizing data analysis and consulting skills, identify deficiencies in physician encounter submission processes and develop comprehensive, provider-specific plans to increase encounter submission rates and accuracy resulting in improved outcomes and RAF performance.
Educate providers on how to improve their Risk Adjustment Factor (RAF) scores, and Quality metrics, which measure their patients' health status.
Reach out to physicians, medical groups, IPAs and hospitals, to build positive, long-term, consultative relationships.
Develop comprehensive, provider-specific plans to increase their RAF performance.
Train providers on our Risk Adjustment and Quality programs and tools, and work toward the adoption of these programs in to their practices.
Collaborate with doctors, coders, facility staff and a variety of internal and external personnel on a wide scope of Risk Adjustment and Quality education efforts.
**Market Consultant will spend four days/week in the field and must reside within commutable distance of the market. When not in the field, Consultant will work out of own home. Must have a reliable car in order to travel to provider offices. Mileage is reimbursed. **
Keywords: Provider education, provider relations, pharmaceutical, sales, healthcare, New Jersey
Job Requirements:
-Bachelor's Degree
- Bilingual in Spanish - required
-Pharmaceutical Sales Experience (Preferred) and/or 1-3 years of experience
Network Management, Contracting, Sales or Consulting.
-Intermediate knowledge of Managed Care and Medicare programs.
-2+ years experience giving group presentations
-Intermediate proficiency in Microsoft Word, Excel and PowerPoint is required.
-Clinical, HEDIS and CMS Stars Rating background preferred
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
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
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