Provider Relations Coordinator
About The Position
The Provider Relations Coordinator serves as a liaison between Optum and its provider network, providing responsive support, issue resolution, and administrative coordination to promote provider satisfaction and operational efficiency. The role supports provider communications, provider data and onboarding processes, network record maintenance, and provider education and engagement. It also supports quality improvement by preparing performance reports, scorecards, meeting materials, and action plan documentation; conducting provider and member outreach; and supporting HEDIS, CMS, CAHPS, and other performance measures. The Coordinator collaborates across departments to address provider concerns, support escalation management, monitor network trends, and contribute to provider growth, retention, and network performance. The position is located at 9 Technology Dr, Irvine, CA 92618, with hours Monday through Friday, 8 a.m. to 5 p.m. The role offers hourly pay from $20.00 to $36.00, based on full-time employment. The company describes a comprehensive benefits program, performance rewards, and development opportunities.
Requirements
- High school diploma.
- At least 1 year of health plan, managed care organization, medical group physician office, IPA, or related work experience.
- At least 6 months of experience working in a team-oriented environment.
- Intermediate experience with Microsoft Suite.
Nice To Haves
- At least 2 years of experience in a health plan, managed care organization, medical group physician office, or IPA setting.
- Excellent communication skills.
- Provider Relations experience or experience working with physicians or physician offices.
- Experience collaborating with diverse, cross-functional teams to achieve shared objectives.
Responsibilities
- Serve as a point of contact for the physician network and respond to physician needs.
- Respond to provider issues within one business day, coordinate with other groups to resolve them, and keep providers and office staff updated through resolution.
- Research and resolve issues reported to Optum by network providers.
- Conduct email or telephone outreach to the provider network to address member inquiries and concerns submitted through Optum’s Patient Service Center.
- Support the Provider Relations escalation process by triaging issues, monitoring turnaround times, and participating in provider outreach and issue resolution.
- Assist with review, tracking, and data collection for providers during Network Services onboarding and update processes.
- Distribute targeted network communications by email, fax, and mail as directed.
- Provide administrative support to Provider Relations Managers (PRMs) and the Provider Relations Department, and participate in assigned special projects.
- Set up and maintain provider electronic files.
- Maintain accurate and timely provider information in Optum databases, including the PRM database.
- Ensure provider offices have applicable Curo, Optum Pro, and DataCORE accounts, and help resolve questions or issues involving these systems and other practice tools.
- Support HEDIS, CMS, CAHPS, and other quality performance measures by engaging targeted provider practices and members and collaborating on improvement workplans.
- Prepare monthly performance scorecards, reports, meeting materials, and action plan documentation for practice performance reviews, JOMs, performance improvement initiatives, and other requested needs.
- Align strategies with regional support teams, including Network Services, Population Health, and Government Programs.
- Conduct member or provider outreach for performance improvement, including data collection, quality gap closures, appointment scheduling, and quality education.
- Monitor membership decline trends and escalate findings to leadership as appropriate.
Benefits
- Paid Time Off accrued starting with the first pay period and 8 paid holidays.
- Medical plan options and participation in a Health Spending Account or Health Savings Account.
- Dental insurance.
- Vision insurance.
- Life and AD&D insurance.
- Short-term disability coverage.
- Long-term disability coverage.
- 401(k) savings plan.
- Employee Stock Purchase Plan.
- Education reimbursement.
- Employee discounts.
- Employee Assistance Program.
- Employee Referral Bonus Program.
- Voluntary benefits, including pet insurance, legal insurance, and long-term care insurance.
- Performance rewards and incentive and recognition programs.
- Development opportunities for other roles.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
