Remote Utilization Management Jobs in Rochester, NY

Who You Are
You're a collaborative professional, driven by the potential to make a meaningful impact in healthcare. The challenges of healthcare don't deter you-instead, you see them as opportunities to find innovative solutions that benefit the partners, people, and communities we serve. Honest Health's commitment to purpose, innovation, communities, and kindness resonates with you, inspiring you to bring commitment, creativity, and compassion into your work. You're ready to join a team focused on reimagining primary care for a healthier future that benefits all.
Does this sound like you? Let's connect.
Who We Are
At Honest Health, we believe in purpose and partnership to lead the transformation in primary care. Our team of healthcare experts and clinicians collaborates with a range of stakeholders-from health systems, physician organizations, and payers to providers, practices, and patients - to deliver innovative solutions that elevate care, control costs, and support long-term health. Guided by our core values, we're creating a value-driven model that creates lasting benefits for everyone, now and into the future.
For us, that's just an Honest day's work.
Your Role
The Physician Practice Partner (PPP) will be a relationship builder, facilitator, and change agent supporting the partnership between Honest Health and our partner practices. Your focus will be on helping practices improve their performance in value-based care, aligning with Honest's quadruple aim of improving quality, reducing costs, enhancing patient satisfaction, and promoting the wellbeing of physicians and care teams. You'll work directly with physicians and practice managers, fostering relationships and offering best-practice guidance to achieve high performance in these areas by utilizing Honest programs.
The position is remote, but you must be located in or near Rochester, NY due to the frequency with which you will be engaging with local practices. You will travel up to 70% of the time, frequently visiting assigned practices in person. You'll provide scorecards showing performance opportunities, assist practices in understanding their data, and offer guidance on how to meet key performance metrics related to clinical guidelines, operational processes, and financial outcomes under value-based care.
Primary Functions of the Physician Practice Partner Include:

• Build and maintain strong and collaborative relationships with clinical partners including primary care providers (PCPs), practice managers, and other key stakeholders across integrated networks. Stakeholders may include personnel at skilled nursing facilities (SNFs), specialist practices, and hospital systems.
• Utilize in-person, electronic, and/or telephonic outreach to an assigned portfolio of practices, consulting and discussing relevant information in a concise and influential manner to providers and other stakeholders.
• Assist with onboarding practices to Honest services and influence the successful operationalization of programs while driving your assigned practices toward shared goals and outcomes.
• Educate practices on value-based care opportunities and activities that drive toward optimal cost efficiencies and patient outcomes.
• Be accountable for achieving key performance metrics for assigned practices for utilization, cost of care, documentation, and quality.
• Utilize data to prioritize practice work and develop performance strategies that drive improvements in value-based care programs and outcomes.
• Communicate Honest Health programs/services to the partners' practice engagement teams and coordinate performance tactics across value-based contracts.
• Be the practice point of contact and resource for all Honest operational issues including back office, population health tool support, incentive, quality and CDI questions.
• Maintain accurate documentation on provider engagement and network efforts including contractual documents and Customer Relationship Management (CRM) inputs, as needed.
• Partner with Honest Health's clinical team to support care team objectives related to network goals.
• Show proficiency in Honest Health's business model and speak to insights based on performance data in provider-facing meetings.
• Collaborate cross-functionally internally to identify trends, areas for process improvement, and relationship-building opportunities.
• Provide reports and updates, as needed, to the Director of Market Operations.
• Perform other related responsibilities as assigned.

How You Qualify
You reviewed the Who You Are section of this job posting and immediately felt the need to read on. This makes you a match for our innovative culture. You accept things change quickly in a startup environment and are willing to pivot quickly on priorities.

• Bachelor's degree in healthcare administration or related field is preferred; 4+ years of experience in practice management and/or as a physician specialist in a health system or independent physician association (IPA) may be considered in lieu of a bachelor's degree
• Master's degree in related field is considered a plus
• 5+ years of experience in a healthcare environment, experience successfully engaging PCPs, specialists, and health systems required; experience with value-based care models preferred
• Proven work experience as a Practice Manager or a similar role in healthcare management
• Strong knowledge of clinic operations, medical office management, and experience in clinical supervision and staff management
• Strong knowledge of value based care key performance metrics and clinical performance management including coding, quality and billing
• Proven ability to analyze and interpret reports to identify opportunities for practice success, effectively communicate key components of performance, and translate performance opportunities into practice action plans
• Demonstrated understanding of the healthcare delivery system and value based-care
• Comfortable and productive in a remote work environment, with up to 70% travel to local provider sites.
• Ability to travel frequently to assigned physician practices and demonstrate executive presence in meetings and presentations; practice portfolio may vary based on complexity, but is expected to be approximately 20- 25
• Must have reliable access to high-speed internet to ensure seamless remote work communication and productivity
• Ability to manage multiple priorities and keep up with Medicare policies, processes, and procedures
• Ability to arrange and consistently travel to various work sites, as well as possess and maintain a valid driver's license in your state of residence and motor vehicle insurance
• Exceptional verbal, written, and interpersonal communication skills required
• Resilience and adaptability that will arise with daily interactions with providers
• Effective organizational and time management skills
• Detail-oriented, mission-driven, entrepreneurial, and operates with a sense of urgency

The base pay range for this role is $84,200.00 - $96,800.00. Compensation takes into account several factors including but not limited to a candidate's experience, education, skills, licensure and certifications, and organizational needs. Base pay is just one piece of the total rewards program offered by Honest. Eligible roles also qualify for short-term incentives and a comprehensive benefits package.
Honest Health is committed to ensuring fairness, opportunity, strong teams, and full integration of team members into the organization. We take proactive steps to ensure all applicants are considered for employment based on merit, without regard to race, color, religion, sex, national origin, disability, Veteran status, or other legally-protected characteristics.
Honest Health is committed to working with and providing reasonable accommodations to job applicants with physical or mental disabilities. Applicants with a disability who require a reasonable accommodation for any part of the application or hiring process should email talent@Honesthealth.com for assistance. Reasonable accommodation will be determined on a case-by-case basis.