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Provider Data Performance Account Manager - Minnetonka, MN

UnitedHealth Group

Minnetonka, MN
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Job Details

745607 Provider Data Performance Account Manager Minnetonka MN

Provider Data Performance Account Manager - Minnetonka, MN (745607)

Position Description

The trend is clear: CMS Star ratings are improving, the market is becoming increasingly competitive, and members will continue to prefer Four Star and higher-rated plans (weighted by enrollment, 4+ Star plans serve almost 60 percent of enrollees). The financial return of achieving Star ratings of 4+ is substantial, enhances our brand in the market, and is commensurate with who we are as a company.


The UHG Stars reporting efforts are complex.  The program is supported by diverse technologies and processes, delivered in some cases in siloes.  Many of the processes are manual, and the teams that own individual processes work in different parts of the UHG organizations. 


Overall efficacy of Stars gap closure and reporting is hampered by the diversity of the supporting technologies and the complexity and diversity of the manual processes.


The Provider Data Performance Account Manager is responsible for overall data quality; completeness and timeliness of provider data from providers within the region support the M&R goal to achieve 4+ Star rating.


The ultimate goal of the role is to drive toward a comprehensive ‘data footprint’ that includes all data from all provider entities (Ambulatory, Facilities, Labs, HIEs, etc.).


Provider Data Performance Account Manager Responsibilities: Partnership with the Market

  • Must be able to cultivate Strong Partnership with M&R Operational Peers
  • Works as a technical liaison in cohesion with operational counterpart to execute acquisition of data from providers, specialists, and other entities
  • Leads cross functional efforts on the technical side for process improvement and communication to data acquisition team leadership
  • Directly involved with elevated, prioritized provider group issues to help resolve and drive solutions for data collection
  • Monitors, Reports, and Communicates process flow for intake of data and timeliness of processing
  • Ability to problem solve including multiple priorities and research conflicting and/or inaccurate data. Working knowledge of electronic medical records
  • Manage issues by proactively reporting progress and working with cross functional peers to resolve
  • Serve as Provider Data Acquisition SME to internal local teams and external providers for all data acquisition processes
  • Serve as market SME to campaign leaders ensuring campaigns meet local market requirements and nuances

Primary Responsibilities:

  • Oversight and project management responsibilities for the successful implementation of clinical data exchange implementations with key providers (may include capturing data from various data sources including EMR (Electronic Medical Record), HIE (Health Information Exchange), data marts, etc.)
  • Manage implementations through effective use of project plan and project management discipline
  • Engage with providers to discuss requirements and process for setting up clinical data exchanges
  • Collaborate with market management to identify and engage key providers to collect member encounter and clinical data
  • Lead cross-functional teams to drive projects to completion within committed timelines
  • Communicate effectively to manage expectations of clients and providers
  • Provide timely and accurate progress updates and reporting related to current project status for each implementation
  • Identify, manage, and mitigate risks and issues impacting implementations
  • Participate in development, maintenance, and improvement of implementation processes

Required Qualifications:

  • 5+ years of project management experience
  • Ability to manage multiple implementation projects at one time
  • Ability to adapt to a fast-paced, quickly changing environment
  • Ability to effectively implement and lead change management
  • Member encounter/clinical data experience
  • Strong communication skills
  • Strong leadership skills
  • Client relationship management skills
  • Understanding of HIPAA and PHI compliance
  • Proficient with MS Office Suite (Word, Excel, PowerPoint, Project)
  • Proficient at using SharePoint

Preferred Qualifications:

  • Clinical background/training (RN, NP, Pharm.D, etc.) or ability business experience absorbing clinical quality specifications with the ability to speak with confidence
  • Provider-facing experience
  • EMR system experience
  • General understanding of CMS Stars ratings and HEDIS
  • General understanding of standard health care file formats included CCD, HL7, etc.

Careers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in health care. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.(sm)



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: project management, compliance, EMR, HEDIS, HIPAA, PHI, Medicare, coding, Minnetonka, MN

Job Details

  • Contest Number745607
  • Job TitleProvider Data Performance Account Manager - Minnetonka, MN
  • Job FamilyInformation Technology
  • Business SegmentMedicare and Retirement

Job Location Information

  • Minnetonka, MN
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelDirector
  • ShiftDay Job
  • TravelYes, 25 % of the Time
  • Telecommuter PositionNo
  • Overtime StatusExempt

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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