Provider Relations Advocate ~ Kansas – 378285

Description

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, long term care and/or home and community based organizations, 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:

• 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.

This product will be new to the Kansas market and include outreach for Long Term Care as well as Home and Community Based Service providers. This will be primarily field-based with frequent on-site visits and meetings.

Qualifications

Requirements:

• Undergraduate degree is strongly preferred.
• 2+ years of provider relations and/or provider network experience.
• Intermediate level of proficiency in claims processing and issue resolution.
• 1+ years experience with Medicare and Medicaid regulations is strongly preferred.
• 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.
• Intermediate level of proficiency with MS Word, Excel, PowerPoint and Access.

UnitedHealthcare Community & State 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.

If you’re ready to help make health care work better for more people, you can make a historic impact on the future of health care at UnitedHealthcare Community & State.

We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.

This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all – it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.

You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.

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.