|

Get new similar jobs by email for

Provider Relations Advocate - ...

By continuing you agree to Monster's Privacy policy, Terms of use and use of cookies.
Excellence. It's a start.
Shanterra
Yoga Instructor
Recruiter

Careers at UnitedHealth Group. We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these select few, we offer the global reach, resources and can-do culture of a Fortune 17 company. We provide an environment where you're empowered to be your best. We encourage you to take risks. And we offer a world of rewards and benefits for performance. We believe the most important is the opportunity to do your life's best work.℠

Provider Relations Advocate - OHIO Telecommute

Description:

Position Description:

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)


Positions in this function are accountable for the full range of provider relations and service interactions within UHG, including working on end-to-end provider claim and call quality, ease of use of physician portal and future service enhancements, and training & development of external provider education programs. Designs and implements programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Directs and implements strategies relating to the development and management of a provider network. Identifies gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs. May also be involved in identifying and remediating operational short-falls and researching and remediating claims.

The Provider Relations Advocate is responsible for the full range of provider relations and service interactions within UnitedHealth Group, including working on end-to-end provider claim and call quality, ease of use of physician portal and future service enhancements, and training & development of external provider education programs. Provider Relations Advocates design and implement programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Responsibilities also include directing and implementing strategies relating to the development and management of a provider network, identifying gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs, and may also be involved in identifying and remediating operational short-falls and researching and remediating claims.

Primary Responsibilities:
  • Use pertinent data and facts to identify and solve a range of problems within area of expertise.
  • Investigate non-standard requests and problems, with some assistance from others.
  • Work exclusively within a specific knowledge area.
  • Prioritize and organize own work to meet deadlines.
  • Provide explanations and information to others on topics within area of expertise.
  • A successful candidiate will have managed care and provider relations experience.
  • Analyzes and investigates.
  • Provides explanations and interpretations within area of expertise.
  • Field-based; Frequent on-site visits and meetings with physician groups or hospital systems. Smaller practices, lower spend & less complexity

Applicants must reside within Ohio to be considered for this role.

Qualifications:

Required Qualifications:
  • Bachelor's Degree or High School Diploma/GED AND 5+ years of Provider Relations experience
  • 2+ years of experience working with Providers and/or Provider Relations
  • 1+ year of experience with Medicaid and/or Medicare
  • 1+ year of experience with claims issue resolution
  • Intermediate (or higher) level of proficiency with MS Word, Excel, Outlook, and PowerPoint
  • Ability and willingness to travel up to 25% within the state of Ohio

Preferred Qualifications:

  • Master's or MBA
  • Previous experience with Behavioral Health Providers
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SM


Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

Apply HereJob Category: Marketing/Product
Job Reference Code: 557578-3
Position Type: Full Time, Employee

tag

Quantcast