Provider Relations Advocate - Remote

UnitedHealth Group•Dallas, TX

1d•$60,200 - $107,400•Remote

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Positions in this function are accountable for the full range of provider relations and service interactions within UHG, including working on end-to-end provider claim and call quality, ease of use of physician portal and future service enhancements, and training & development of external provider education programs. Designs and implements programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Directs and implements strategies relating to the development and management of a provider network. Identifies gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs. May also be involved in identifying and remediating operational short-falls and researching and remediating claims. Employees in jobs labeled with ‘SCA’ must support a government Service Contract Act (SCA) agreement. There are changes happening in health care that go beyond the basics we hear in the news. People like you and organizations like UnitedHealth Group are driving ever higher levels of sophistication in how provider networks are formed and operate. The goal is to improve quality of service while exploring new ways to manage costs. Here's where you come in. You'll use your strong customer service orientation and knowledge of insurance claims to serve as an advocate for providers in our networks. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 6 leader. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Requirements

High school diploma or equivalent experience
5+ years of health care/managed care experience
3+ years of provider relations and/or provider network experience
1+ years of experience with Medicare and Medicaid regulations
Intermediate level of proficiency in claims processing and issue resolution
Proficiency with MS Word, Excel, PowerPoint and Access
Driver’s License and access to reliable transportation
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Candidates are required to pass a drug test before beginning employment.

Responsibilities

Assist in end-to-end provider claims and help enhance call quality
Coach, provide feedback and guide others
Assist in efforts to enhance ease of use of physician portal and future services enhancements
Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers
Help implement training and development of external providers through education programs
Identify gaps in network composition and services to assist network contracting and development teams
Communicate about ways to evolve ongoing processes and programs with senior management and physicians