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 Associate Director of Provider Service 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. Associate Directors of Provider Service 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. Primary Responsibilities: Own an end to end processDevelop functional, market level, and / or site strategy, plans, production and / or organizational prioritiesIdentify and resolve technical, operational and organizational problems outside own teamProduct, service or process decisions are most likely to impact entire functions and / or customer accounts (internal or external)This position is responsible for the management of innovative network initiatives within the 5 States of the Northeast, which encompasses approximately 22,263 providers, group agencies and hospitals. Additionally this region has several blue chip Independent Health Plan relationships which include Harvard Pilgrim Health and Oxford and critical employer groups such as ACUSHNET, ANALOG DEVICES, INC., ADVANTAGE and GEThis position is responsible for the management of several projects which include but is not limited to: MBI, Value Based Contracting, TMS and telemental expansionThis position is accountable for the full range of provider relations and service interactions within Optum, 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 programsDesigns and implements programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managersDirects 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 needsMay also be involved in identifying and remediating operational short - falls and researching and remediating claims
Required Qualifications: 7+ years of provider relations and / or network management experience 5+ years of direct supervisory management experience Advanced level of knowledge of medical claims / systems processes, contracting and reimbursement methodologies 5+ years of experience with Medicare and Medicaid regulations Advanced level of proficiency with MS Word, Excel Ability to travel regionally about 25% of the time, with potential for overnight travelPreferred Qualifications: Undergraduate degree Project management experience 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 Proficiency with Cosmos, MS PowerPoint, MS Access Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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.(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: Waltham, Boston, Springfield, Amherst, Worcester, MA, Massachusetts, Provider Relations Director, training, development, provider network, telecommute, telecommuter, remote, work from home
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.