Provider Relations Manager - Remote in Kansas

UnitedHealth Group Inc.•Overland Park, KS

37d•Remote

About The Position

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together This role requires 50% travel in the state of Kansas. In this role, you will be expected to actively support and implement health plan initiatives by guiding the Provider Advocate team in executing defined strategies and priorities. You will collaborate with internal stakeholders to ensure operational alignment, address provider group challenges, and contribute to measurable improvements in provider experience and service delivery. Your responsibilities will also include supporting the development and management of the provider network by identifying gaps in network composition and services to assist contracting and development staff in prioritizing needs. You may also be involved in identifying and remediating operational shortfalls and supporting claims resolution efforts. This role requires a proactive approach to team leadership, a commitment to advancing organizational goals, and a focus on building and maintaining trusting, sustainable relationships with providers to better serve the health needs of our members and their patients. If you are located in Kansas, you will have the flexibility to work remotely as you take on some tough challenges. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Years of post graduate experience can be substituted

Requirements

3+ years of experience with Medicare and Medicaid regulations
2+ years of provider relations experience
Experience in a lead or supervisory role
Experience using reporting tools or systems to track issue management, monitor progress, and support project execution
Solid understanding of Medicaid program operations, managed care, and provider engagement strategies
General understanding of healthcare recovery processes, including payment adjustments, remittance advice, and how negative balances may impact provider experience
Familiarity with claims and provider data platforms (e.g., NDB, Facets, CLM, OHBS, CSP Facets, DOC360, ICUE), or similar systems, with an understanding of how these tools support provider contracting, claims remediation, and reimbursement methodologies
Familiarity with Kansas State's provider enrollment systems, revalidation processes, and provider/type specialty requirements for billing covered services under the State plan
Proven ability to guide and support team members in executing defined initiatives, ensuring alignment with operational priorities, performance expectations, and organizational standards
Proven exceptional communication and presentation skills, with the ability to engage diverse audiences and build trust
Proven ability to build and maintain effective relationships with internal and external stakeholders
Proven self-directed and analytical, with strong critical thinking and problem-solving skills
Proven comfort communicating across all organizational levels, from front-line staff to senior leadership

Nice To Haves

Undergraduate degree
All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Responsibilities

Guide and support team members in executing defined health plan initiatives, ensuring day-to-day alignment with operational priorities, performance expectations, and organizational standards
Assess and interpret provider needs and requirements
Identify solutions to non-standard requests and problems
Solve moderately complex issues (claims, portal, provider data, etc.) while working under minimal guidance, seeking support for the most complex tasks
Provide explanation and information on difficult issues
Identify, organize, track, and deliver on identified solutions
Support initiatives to achieve measurable service experience improvements in the health plan
Set Advocate field staff up for success through guidance, support, and issue resolution
Coordinate extensively with cross-functional internal teams to understand and address provider group challenges
Develop an intimate knowledge of provider practices
Bring the "voice of the provider" to help shape internal initiatives and nurture relationships