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) 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, physician providers 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 expertiseInvestigate non - standard requests and problems, with some assistance from othersWork exclusively within a specific knowledge area Prioritize and organize own work to meet deadlinesProvide explanations and information to others on topics within area of expertiseThis provider advocate role is based in the Cypress, CA, office location. It is an external - facing field position with primarily phone and email interactions with providers, and serves the Los Angeles market. There is regional travel associated with this position, about 5% of the time, travelling on average once or twice per month.
Required Qualifications:Undergraduate degree or equivalent combination of education and relevant experience 2+ years of provider relations and / or provider network experienceIntermediate level of proficiency in claims processing and issue resolutionExceptional presentation, written and verbal communication skillsAbility to work independently and remain on taskGood organization and planning skillsAbility to prioritize and meet deadlines from multi-staff members within the departmentProficiency with MS Outlook, Word, ExcelAbility to travel regionally approximately 5% United States CitizenshipAbility to obtain favorable adjudication following submission of Department of Defense eQuip Form SF86Preferred Qualifications:Experience with Medicare and Medicaid regulationsExperience working in large matrixed organizationProficiency with MS PowerPoint and SharePointExperience with the following platforms: ISET, Nice, NDB, Emptoris, Facets, POPS As a requirement of UnitedHealth Group's contract with the Department of Defense, this position requires U.S. citizenship and proof of favorable adjudication following submission of Department of Defense eQuip Form SF86, (the National Agency Check Legal and Credit or NACLC). Successful completion of the NACLC process is a requirement for continued employment in this role. NACLC processing will be initiated by our TRICARE Security Officer post-offer, and can take 3-6 months for a final decision communication from the Department of Defense. Candidates will be allowed to begin employment with UnitedHealth Group in this role based on an interim clearance, and final results will be communicated as they are received. Failure to obtain final NACLC approval will result in termination from this role. Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SM Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.Job Keywords: account manager, contract, capitated, capitation, delegated, network, healthcare, medical , hospital, claims resolution, Cypress CA, California
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.