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Practice Advocate

Company: Optum
Location: Tacoma
Posted on: October 17, 2020

Job Description:

Practice Advocate

Northwest Physicians Network is now offering qualified candidates an opportunity to join our team as a Practice Advocate . Our company values innovative problem solvers promote personal and professional growth and provides a supportive working environment that affords all of its employees a healthy work/life balance.

This position is responsible for engaging and supporting the relationship with Northwest Physicians Network (NPN) providers and practice staff who are valuable Network partners. Drives Network performance in population health and managed care (including quality, care management, and utilization “total cost of care” management) with the ultimate goal of improving patient care and provider experience.  Serves as a change agent to drive performance on key metrics and leading indicators, proactively utilizing data/analytics as well as firsthand knowledge procured from strong relationships with Network practices.  Primary focus is on small and medium size clinics within the Network.

Northwest Physicians Network creates the opportunity for independent private practitioners to thrive in Washington State. By providing clinical integration support and data driven quality improvement, we have created a high value delivery network, making it possible for our providers to remain focused squarely on their patients.

Status: Regular, Full-time, FLSA Exempt

Competitive Benefits

Essential Functions and Responsibilities:

Primary Scope

Serves as a single-point-of-contact and relationship owner to the IPA Network practices; is an accountable owner who is responsive to Network provider and practice needs

Builds continuous and collaborative relationships with NPN providers and their practice staff

Advocate uses data to identify trends and opportunities for the business and clients; develops business strategies in line with company strategic initiatives and presents information for operational and business planning

The Practice Advocate is paired with a Network Medical Director clinical dyad partner. Dyad is responsible for partnering with Network practices to implement individualized performance strategy initiatives and goals for region of responsibility.  Monitors progress, intervenes, and escalates issues or concerns as appropriate

Co-leads regular joint operating committee (“JOC”) meetings with large medical groups.  Provides executive level summaries, education, and action plans to identify performance opportunities on population health KPIs

Works collaboratively with the Network Development team to onboard new practices and integrate them into daily operations

Facilitates practice engagement in the following areas: Action plans for risk adjustment and clinical quality performance improvement

Shifting providers from a fee-for-service focus to value-based models of care

Education of utilization and care management initiatives

Submission of patient documentation

Compliance education

Troubleshooting of claims and prior authorization issues

Adheres to a scheduled cadence for touchpoints and ensures that agreed upon agenda is followed and action items are documented and tracked including: Minimum of once a quarter touch points with Network practices to include discussions on performance reporting with practice staff and/or providers

Facilitation, including the compilation of presentation materials and scheduling, for quarterly Joint Operating Committees (JOCs)

Works closely with all functional areas within NPN to deliver clear communications, education, and exemplary service to the NPN Network practices

Works across all functional areas to appropriately research, triage, and escalate complex queries from clinics in need of increased attention to reach a point of resolution

Represents NPN at community and other provider meetings

Regularly collects and reports feedback and recommendations from practices regarding potential opportunities Maintains awareness of providers interested in further engagement with NPN for new business opportunities, including market insights that would impact the Network and NPN

Maintains, utilizes, protects, and discloses NPN patient’s protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPPA) standards

Performs other duties as assigned

Knowledge, Skills and Abilities:

Strong interpersonal skills with the ability to maintain collaborative working relationships at all levels of the organization required

Ability to prioritize and organize work to meet multiple deadlines and quickly re-prioritize when necessary

Ability to work independently, use good judgment and decision-making process

Ability to resolve problems to completion and evaluate options to implement solutions. Proactive approach to identify issues and determining root cause/s so issues can be resolved timely and completely

Ability to document, track, triage, and follow and/or close issues in a timely manner. Expected response time is within one (1) business day for provider issues to include updating providers and their office staff regularly until resolution

Ability to work effectively under deadlines, frequent interruptions, and changing priorities

Travel 50% of the time to geographic region of responsibility

Ability to adopt quickly to change in an ever-changing environment

General knowledge of Medicare and Medicaid risk-based contracts

Risk adjustment experience strongly recommended

Strong work ethic and desire to succeed

Ability to sit down with medical groups of all sizes and develop joint action/work plans

Excellent oral and written communication skills; experience giving group presentations/training

Ability to judge appropriate information to be conveyed to different levels of management

Promote a positive “can do” attitude which inspires other team members

Excellent computer skills, including MS Office Suite and data analysis with the ability to learn and apply new software

Ability to work accurately with detail

Ability to obtain and retain knowledge of cross-functional resources within the organization

Minimum Qualifications:

Education:          Associate’s degree in related field required. (Two additional years of comparable work experience beyond the required years of experience may be substituted in lieu of an Associate’s degree). Bachelor’s Degree preferred with a significant understanding of medical care financing and delivery systems, provider contracting, reimbursement arrangements and network management.

Experience:        Minimum of 3 years working directly within a Health Care and/or Managed Health Care (HMO) field, including provider relations or related experience in a physician’s practice, clinic environment, or performance or quality improvement

Keywords: Optum, Tacoma , Practice Advocate, Other , Tacoma, Washington

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