Sr Provider Relations Liaison - Comm. Network Operations - Pearland Admin Office - Kelsey Seybold Clinic

UnitedHealth Group Inc.•Pearland, TX

48d

About The Position

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. The Senior Provider Relations Liaison is responsible for establishing and maintaining solid positive business relationships with current and potential Kelsey-Seybold and KelseyCare Advantage affiliate and employed providers to ensure stable and geographically disperse networks for the Kelsey-Seybold commercial and Medicare Advantage health plans and KS Plan Administrators' health plan products.

Requirements

5+ years of professional level experience in clinic or healthcare operations
CPT and ICD-10 coding and prior experience with reimbursement methodologies
Proven knowledge of claims processing, clinic operations, managed care plan benefits and utilization management policies and procedures
Network development and/or provider relations experience
Microsoft Word and Excel experience
Proven analytical and problem-solving skills; ability to communicate effectively in writing and verbally
Proven public speaking and presentation skills
Valid Texas Driver's License and ability to travel
Own or lease a working vehicle and be able to travel daily within the Greater Houston area

Nice To Haves

5+ years of experience in applicable healthcare administrative operations
3+ years of experience in Medicare/Commercial products
Ability to interpret provider contracts and regulatory contracts
Experience with the development of provider relations and/or clinical networks
Ability to work in a fast-paced environment; demonstrated ability to perform multiple concurrent tasks with minimal supervision and meet deadlines
Proficiency with Excel and/or PowerPoint
Excellent communication and relationship development skills with multiple different types of stakeholders. Outcomes driven
Capable of managing a variety of complex issues while driving momentum of key projects

Responsibilities

Responsibilities include providing educational instruction and support to physicians and their staff
Be the main point of contact for the respective providers and will routinely visit physician's offices for issues concerning the achievement of quality outcomes, provider satisfaction, medical cost targets, network growth and/or efficiency targets
Responsibility for education of the physicians and office staff on health plan products and benefits, policy and procedure for multiple managed care plans, assistance with claims payments and other duties as assigned
Travel requirements - local and extensive