About the position
Optum Home & Community Care, part of the UnitedHealth Group 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 naviHealth product, we help change the way health care is delivered from hospital to home supporting patients transitioning across care settings. This life-changing work helps give older adults more days at home. We're connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together. 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 is where you come in. You will use your solid customer service orientation and knowledge of insurance claims to serve as an advocate for providers in our networks. As you do, you will discover the impact you want and the resources, backing and opportunities that you would expect from a Fortune 4 leader. A highly engaged provider network is critical to ensure members receive the right care at the right place for the right amount of time. The Provider Relations Manager develops and maintains an ongoing collaborative relationship with providers, based on mutual respect, high-quality outcomes, and patient satisfaction. The role works to continually shape the network landscape, by offering objective data and education to all stakeholders in the market. In its highest functional state, it is the Provider Relations Manager who supports the provider in ensuring recognition by the hospital and plan partners through appropriate application of best practices in quality, efficiency, and process management. The market for this role is Tennessee, Alabama, Mississippi, and Louisiana.
Responsibilities
- Develop relationships with providers/payers and support the patient-centric model during new implementations
- Maintain positive working relationships with providers/payers to build a high quality, highly receptive network base in mature markets
- Lead network issue resolution
- Deliver ongoing analytics and support materials for providers
- Work closely with market presidents and senior clinical managers to monitor and improve hospital DC referral patterns, par and non-par home health agencies, and closed record statistics
- Collaborate closely with provider relations leadership
- Coach, provide feedback and guide others
- Assist in efforts to enhance ease of use of provider portal and future services enhancements
- Contribute to design and implementation of programs that build/nurture positive patient and provider experiences
- 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
Requirements
- Healthcare experience
- 3+ years of experience collaborating with providers or related account management roles
- Driver's License and access to a reliable transportation
Nice-to-haves
- Clinical licensure - RN, PT, OT, or ST
- 5+ years of health care/managed care experience
- 3+ years of provider relations and/or provider network experience
- Experience across the acute and post-acute care continuum
- Proficiency in claims processing and issue resolution
- Proficiency with MS Word, Excel, PowerPoint, and Access
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution
