Field Sr. Practice Support Specialist - Houston, TX
Company: Optum
Location: Houston
Posted on: February 17, 2026
|
|
|
Job Description:
Explore opportunities with WellMed, part of the Optum family of
businesses. We believe all patients are entitled to the highest
level of medical care. Here, you will be part of a team who shares
your passion for helping people achieve improved health outcomes.
Explore rewarding opportunities for physicians, clinical staff and
non-patient-facing roles. Join us and discover the meaning behind
Caring. Connecting. Growing together. The Sr. Practice Support
Specialist (PSS) serves as a clinical liaison between contracted
primary care practices and WellMed contracted clinical operations.
This role is designed to drive value-based care performance and
reduce avoidable utilization through proactive patient outreach,
coordinated clinical interventions, and improved provider
engagement. The PSS supports practices in managing high-risk
patients and implementing population health strategies aligned with
organizational priorities. This role reports to the Provider
Relations Leader and works in a matrixed leadership environment.
Clinical activities will occur under the direction of the WellMed
Senior Medical Director and in accordance with Company protocols,
established nursing practice standards, and the relevant state
regulatory requirements. The role is field-based with an expected
travel requirement of 75-85% to contracted provider offices.
Primary Responsibilities: Care & Value Optimization - Manage
patient census across assigned practices, focusing on high-risk and
high-cost cohorts - Monitor and influence key utilization metrics:
ER visits, Admits/K, Readmits/K, SNF/ASC/hospital usage, and
palliative care engagement - Serve as a liaison between PCPs,
hospitalists, specialists, and care management programs to ensure
coordinated care delivery - Support practices in implementing
contingency plans for high-risk patients (HF, COPD), including
documentation of advanced directives and care bundle elements -
Conduct weekly touchpoints with the medical director dyad partner
to review admissions and determine escalations to contracted
providers - In partnership with PBM and Medical Director team,
analyze utilization and performance data to identify trends and
root causes - Develop action plans aligned with market goals
(quality, cost, coding) - Produce and share scheduled/ad-hoc
reports on key metrics Patient Coordination & Engagement - Ensure
monthly visits for Band 5 and other high-risk cohorts per
prioritization list - Facilitate timely follow-up for hospital
discharges and transitions of care - Conduct weekly 'tuck-in calls'
to high-risk members - Provide education on 'call us first' -
Assist practices in managing high-cost patients and ensuring
follow-up on screenings and lab measures Referral & Specialist
Strategy - Support referral management aligned with preferred
specialist strategy - Facilitate Tier 1 Cardiology/HF clinic
referrals and support optimization of guideline-directed medical
therapy (GDMT) Quality & Risk Adjustment Support - Provide
education and baseline support for risk adjustment documentation
before coder SME engagement - Drive timely closure of care gaps
(medication adherence, preventive screenings, HEDIS/STAR measures)
- Assist practices in understanding and applying QRA strategies
You'll be rewarded and recognized for your performance in an
environment that will challenge you and give you clear direction on
what it takes to succeed in your role as well as provide
development for other roles you may be interested in. Required
Qualifications: - Associates Degree in Nursing - Current,
unrestricted RN license required, specific to the state of
employment or able to obtain compact license within 30 days of hire
- 4 years in any combination of provider relations, network
management - Experience with Medicare Advantage, HEDIS, STAR, CMS
reimbursement models, risk adjustment - Proven solid analytics,
communication, relationship-building, and proficiency in Microsoft
Office - Ability to travel extensively (up to 75-85%) - Driver's
License and access to reliable transportation Preferred
Qualifications: - Bachelor's degree in Business or Healthcare
Administration - CPC Certification - Experience in value-based care
or population health management, care management, and/or clinical
operations Pay is based on several factors including but not
limited to local labor markets, education, work experience,
certifications, etc. In addition to your salary, we offer benefits
such as, a comprehensive benefits package, incentive and
recognition programs, equity stock purchase and 401k contribution
(all benefits are subject to eligibility requirements). No matter
where or when you begin a career with us, you'll find a
far-reaching choice of benefits and incentives. The salary for this
role will range from $72,800 to $130,000 annually based on
full-time employment. We comply with all minimum wage laws as
applicable. At UnitedHealth Group, our mission is to help people
live healthier lives and make the health system work better for
everyone. We believe everyone-of every race, gender, sexuality,
age, location and income-deserves the opportunity to live their
healthiest life. Today, however, there are still far too many
barriers to good health which are disproportionately experienced by
people of color, historically marginalized groups and those with
lower incomes. We are committed to mitigating our impact on the
environment and enabling and delivering equitable care that
addresses health disparities and improves health outcomes - an
enterprise priority reflected in our mission. UnitedHealth Group is
an Equal Employment Opportunity employer under applicable law and
qualified applicants will receive consideration for employment
without regard to race, national origin, religion, age, color, sex,
sexual orientation, gender identity, disability, or protected
veteran status, or any other characteristic protected by local,
state, or federal laws, rules, or regulations. UnitedHealth Group
is a drug - free workplace. Candidates are required to pass a drug
test before beginning employment.
Keywords: Optum, Baytown , Field Sr. Practice Support Specialist - Houston, TX, Healthcare , Houston, Texas