Position Description:Energizeyour career with one of Healthcare's fastest growing companies. Youdream of a great career with a great company – where you can make an impact andhelp people. We dream of giving you theopportunity to do just this. And withthe incredible growth of our business, it's a dream that definitely can cometrue. Already one of the world's leading Healthcare companies, UnitedHealthGroup is restlessly pursuing new ways to operate our service centers, improveour service levels and help people lead healthier lives. We live for the opportunity to make adifference and right now, we are living it up. Thisopportunity is with one of our most exciting business areas: Optum –a growingpart of our family of companies that make UnitedHealth Group a Fortune 17 leader. Optum helps nearly 60million Americans live their lives to the fullest by educating them about theirsymptoms, conditions and treatments; helping them to navigate the system,finance their healthcare needs and stay on track with their health goals. Noother business touches so many lives in such a positive way. And we do it allwith every action focused on our shared values of Integrity, Compassion,Relationships, Innovation & Performance.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.The Healthcare 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 services and call quality, ease of use of physician portal and future service enhancements, and training & development of external provider education programs via face to face visits, video and teleconferencing connectivity. 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, review provider contract language, negotiate rates and active involvement in identifying and remediating operational short-falls and researching and remediating claims. This position supports a behavioral health provider network.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 service 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.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 Consistently identify areas for process improvement that streamline processes Act as the main liaison between the provider network and the health plan in several markets within California Build and foster relationships that align partnerships and produce successful results Analyzes and investigates Provides explanations and interpretations within area of expertise
Required Qualifications:High School Diploma / GED (or higher) 2+ years of healthcare network management, contracting and / or a group provider relations experience3+ years of experience with MediCal / Medicaid regulations2+ years of experience with Medicare regulations2+ years of experience in provider education and / or conducting provider presentationsIntermediate level of proficiency in claims processing and issue resolutionStrong knowledge of County behavioral health and community servicesIntermediate level of proficiency with Microsoft Word, Microsoft Excel, Microsoft PowerPoint, and Microsoft Access Ability to travel up to 20% of the time within the State of CaliforniaPreferred Qualifications: Undergraduate Degree (or higher) Experience with Behavioral HealthCareers 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.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.Keywords: Provider relations, provider recruiter, credentialing, network management, provider service, claims, education, engagement, provider relationship management, Provider Network, healthcare, medical, Claims, Credentialing, Medicaid, Medi-Cal, San Diego, CA, Sacramento. CA, Davis, CA, Carmichael, CA, Roseville, 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.