Provider Relations Representative - Missouri
UnitedHealth Group - St. Louis, MO

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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)

UnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus:

UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, affordable benefits services.

UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.

UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.

Together, we're removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being.

The Provider Relations Representative is responsible for assisting in 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 Representatives assist in the design and implementation programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Other responsibilities include supporting those who direct and implement strategies relating to the development and management of a provider network, identify 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:
- Apply basic knowledge of theories, practices and procedures.
- Perform routine or structured work.
- Respond to routine or standard requests.
- Use existing procedures and facts to solve routine problems or conduct routine analyses.
- Depend on others for instruction, guidance or direction.

Come grow and thrive in our culture of innovation and ideas. Because there is no opportunity greater than the quest to help people live healthier lives.

Requirements:

2-4 years of managed care or medical insurance experience

COSMOS platform knowledge

Proven Medicare and Medicaid experience

Strong verbal and written communication skills

Applicant must have the ability to work independently with minimum supervision Able to meet performance metrics (turn around time, issue resolution, and root cause analysis)

Strong research and analytical skills

Good organization and planning skills

Previous adjustment experience within M&R and/or E&I environment strongly preferred

Previous customer service, RRE, PPR, or PCRS experience required
Intermediate level of proficiency with MS Excel and Word

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UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier...