Provider Relations Advocate--Telecommute (370017)
Picis Inc - Trumbull, CT

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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 and 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. In this role you will be expected to:

  • Recruit physicians into the network
  • 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.
  • Frequent visits and meetings with physician groups or hospital systems. Smaller practices, lower spend & less complexity.
  • Position will require travel on occasion.
Qualifications

Requirements:
  • 2+ years of provider relations and/or provider network experience.
  • 2+ years claims processing and/or issue resolution.
  • 3+ years with MS Word, Excel, PowerPoint and Access.
Assets:
  • Managed care work experience with behavioral providers.
  • 1+ years experience with Medicare and Medicaid regulations.
  • Exceptional presentation, written and verbal communication skills.
  • Ability to work independently and remain on task.
  • Good organization and planning skills.
  • Ability to prioritize and meet deadlines from multi-staff members within the department.
  • Undergraduate or higher degree.
OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

OptumHealth helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their health care needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

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.

Picis Inc - 2 years ago - save job - block
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