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) As a Provider Relations Advocate within this function, you will be accountable for the full range of provider relations and service interactions within Optum, including working on end-to-end provider relations, provider education, provider dispute, complex claim resolution, ease of use of provider portal, network development and maintenance, and future service enhancements. You will help design and implement programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. You will help direct and implement strategies relating to the development and management of a provider network. Additionally, you will help to identify gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs. There may also be opportunities to get involved in identifying and remediating operational short-falls and researching and remediating claims. Primary Responsibilities: Communicate directly with providers (largely via phone and/or WebEx, with some occasional regional travel) using pertinent data and facts to identify and solve a range of problems as they relate to Medicaid claims processing or relatedInvestigate non-standard requests and problems, with some assistance from othersPrioritize and organize own work to meet deadlinesProvide explanations and information to others on topics within area of expertise
Required Qualifications: Undergraduate degree3+ years of provider relations and/or provider network experienceIntermediate proficiency in Medicaid in claims research including end-to-end issue resolutionIntermediate proficiency with Medicaid and Medicare regulationsExperience delivering oral and written presentations and/or communicating with providers and other constituents Experience managing multiple priorities simultaneously while successfully meeting deadlines Intermediate level of proficiency with MS Word, Excel, and PowerPointBi-lingual in English/SpanishPreferred Qualifications: Experience with Medicare claims data and/or dual eligible casesAdvanced proficiency in Medicaid claims processing and regulationsCareers 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: providers, Medicaid, excel, issue resolution, southern Florida, West Palm Beach, Miami, Fort Lauderdale, Fort Myers, Naples
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.