Senior Provider Relations Advocate - Riverside County, CA

UnitedHealth Group•Riverside, CA

1d•$72,800 - $130,000•Hybrid

About The Position

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. Optum is redefining health care with a focus on health equity, affordability, quality, and convenience. We are focused on helping patients live healthier lives and helping the health system work better for everyone. At Optum, we care. We care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions. As a Senior Provider Relations Advocate at Optum, you will act as a direct interface between Optum and the affiliated physicians in Optum’s Independent Physician Association (IPA) network and support their operations and performance success. This position provides continuous education, support, training and troubleshooting to physicians and their staff. The office hub for this position is located in Murrieta, CA. This position will require regular travel across South Riverside County including but not limited to Murrieta, Hemet, Temecula, Lake Elsinore, Wildomar, Menifee.

Requirements

3+ years of health care/managed care experience
3+ years of provider relations and/or provider network experience
Experience with Medicare and Medi-Cal regulations
Proven understanding of healthcare systems billing
Intermediate level of proficiency in claims processing and issue resolution
Intermediate level of proficiency with Microsoft Office applications
Proven excellent verbal, written and interpersonal skills required, including experience drafting correspondence and preparing meeting documentation
Ability and willing to work an office-based schedule (in the office 1-2 days per week when not in the field)
Ability and willing to travel 50-75% within assigned territory
Driver’s License and access to reliable transportation

Nice To Haves

Provider recruitment and contracting experience

Responsibilities

Serve as single-point-of-contact to the physician network and is an accountable owner, responsive to physician needs. Knowledgeable about incentive programs, contract reimbursement, Optum’s internal processes and priorities, and other Optum initiatives, as applicable
Monitors performance of assigned PCPs, identifies low performing PCPs and works with IPA leadership to develop action plan for specific metrics needing improvement. Works with office to effectuate action plans and monitors progress
Intervenes and escalate issues as appropriate
Maintains awareness of providers interested in further engaging with Optum on new business opportunities (contracts and business combinations), and on shifting market/competitive dynamics that would impact the IPA
Works collaboratively with offices and Optum growth team to drive membership growth and retention
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
Build collaborative relationships with IPA physicians and their office staff
Attend in person department and training meetings at corporate locations as directed