Provider Relations Coordinator

UnitedHealth Group•Irvine, CA

1d•$20 - $36•Onsite

About The Position

The Provider Relations Coordinator serves as a liaison between Optum and its provider network, delivering responsive support, issue resolution, and administrative coordination to promote exceptional provider satisfaction and operational efficiency. This role supports the Provider Relations Team by facilitating provider communications, collaborating on provider data and onboarding processes, maintaining network records, and assisting with provider education and engagement activities. The Coordinator plays an integral role in quality improvement initiatives by preparing performance reports, scorecards, meeting materials, and action plan documentation; conducting provider and member outreach; and supporting efforts related to HEDIS, CMS, CAHPS, and other performance measures. Additionally, the position collaborates across departments to address provider concerns, support escalation management, monitor network trends, and contribute to provider growth, retention, and overall network performance.

Requirements

Health plan, managed care organization, medical group physician office, IPA, or related work experience
Intermediate level of experience with Microsoft Suite
Experience working within a team-oriented environment
Proven excellent communication skills

Nice To Haves

2+ years of experience in a health plan, managed care organization, medical group physician office or IPA setting
Roles in Provider Relations or experience working with physicians/physician offices
Experience working collaboratively with diverse, cross-functional teams to achieve shared objectives

Responsibilities

Serves as a point-of-contact to the physician network and is responsive to physician needs
Responds timely (within one business day) to provider issues, works with other groups/central departments to resolve issues and updates providers and office staff regularly through to resolution
Assists the Provider Relations team by researching and resolving issues communicated to Optum by network providers
Conducts outreach to provider network as needed via e-mail or telephonically to help remediate inquiries and concerns from members submitted through Optum’s Patient Service Center
Supports Provider Relations Escalation process, through appropriate triage of issues to PR Team members, monitoring turnaround times to ensure timely resposne, and participating in provider outreach and issue resolution
Assists with the review, ongoing tracking and data collection for Optum’s providers through the Network Services’ onboarding and update processes
Distributes targeted network communications through email, fax and mail as directed
Provides administrative support to PRMs and PR Department and participates in special projects as assigned
Assists the Provider Relations team in setting up and maintaining provider e-files
Assists the Provider Relations team in maintaining accurate and timely provider information in Optum databases including, but not limited to, maintaining PRM database
Ensures that provider offices have a Curo, Optum Pro, and DataCORE “account” assigned (as applicable) and assists in the resolution of provider questions/issues related to usage of these systems and other practice tools
Supports quality performance measures (e.g., HEDIS, CMS, CAHPS) by engaging targeted provider practices and members, collaborating on improvement workplans
Develops and prepares monthly performance scorecards, reports, meeting materials, and action plan documentation to support PRMs’ practice performance review discussions, JOMs, performance improvement initiatives and as needed/requested
Collaborates and aligns strategies with other regional support teams (e.g., Network Services, Population Health, Government Programs)
Conducts member or provider outreach in support of performance improvement initiatives including data collection, quality gap closures, appointment scheduling, quality education
Monitors and identifies trends on membership decline and escalates to leadership as appropriate