Provider Engagement Representative - Remote in Michigan
About The Position
Optum Home & Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual’s physical, mental and social needs — helping patients access and navigate care anytime and anywhere. As a team member of our Senior Community Care (SCC) team, we work to provide care to patients at home, nursing homes and assisted living for senior housing. This life-changing work adds a layer of support to improve access to care. We’re connecting care to create a seamless health journey for patients across settings. Join us to start Caring. Connecting. Growing together. The Provider Engagement Representative (PER) will manage business relationships for contracted Skilled Nursing Facilities (SNF) for all UnitedHealthcare Community Plan of Michigan for the Michigan Medicaid program, including working on end-to-end provider issues and call quality, and training & development of external provider education programs. The PER will conduct both in-person and virtual meetings, along with related provider relations activities, to support the overall operations of the Medicaid program If you are located in Michigan, you will have the flexibility to work remotely as you take on some tough challenges.
Requirements
- 2+ years of experience with Medicare/Medicaid regulations
- Experience working in a skilled nursing facility
- Billing experience in a skilled nursing facility
- Demonstrated intermediate level of proficiency with MS Word, Excel, PowerPoint and, Outlook
- Driver’s License and access to reliable transportation
- Ability to travel 25%25 of the time within Michigan
- All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Nice To Haves
- 2+ years of provider relations or provider network management experience
- Ability to prioritize and meet deadlines
- Demonstrated familiarity with claims processing and issue resolution
Responsibilities
- Develop and maintain overall UnitedHealthcare business relationships with Skilled Nursing Facilities
- Serve as the primary point of contact for assigned facilities ensuring timely and effective communication
- Conduct routine outreach (virtual and on-site) to assess provider needs, concerns, and satisfaction
- Designs and implements programs to build and nurture positive relationships between the health plan, nursing facility providers and business office managers
- Direct and implement strategies relating to the development and management of a provider network
- Support all education opportunities on UnitedHealthcare businesses which include in person and telephonic interactions
- Identifies gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs
- Provide explanations and information to others on topics within area of expertise
- Prioritize and organize own work to meet deadlines cross functionally within the organization
- Investigate non-standard requests and issues, prior to escalation if needed
- Compass Data Base - update & maintain regularly with information following interactions with nursing facilities
- Provide outreach and education on updated policies, new initiatives, performance, and others as necessary
Benefits
- a comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
