The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This Provider Relations Advocate role with UnitedHealth Group will call on your knowledge, your energy, and your commitment to making health care work more effectively for more people. We're building better, more effective provider networks every day. In this role, you'll use your strong customer service orientation and knowledge of insurance claims to serve as an advocate for providers in our networks. As you do, you'll discover the impact you want and the resources, backing, and opportunities that you'd expect from a Fortune 5 leader. The Provider Relations Advocate is responsible for the full range of provider relations and service interactions with internal and external customers. Provider Relations Advocates build and nurture positive relationships between health plans, providers (physician, hospital, ancillary, etc.), and practice managers. This position will be responsible for the behavioral health network in the state of Louisiana affiliated with a payor account, which includes, but is not limited to, the following: establishment of a payor relationship related to network maintenance and development, recruitment/contracting outpatient services/facility recruitment nominations, provider file maintenance/demographic validation, provider contractual compliance with BH P&Ps and clinical protocols, working provider/member complaints, developing education materials and education/training of provider network, developing fee schedules, negotiation of rates, maintenance of fee schedule management of providers within assigned territory (LA), and all other duties as assigned.
If you are located in within the state of Louisiana, you will have the flexibility to telecommute* as you take on some tough challenges.
- 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
- Direct and implement strategies relating to the development and management of a provider network
- Identify gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs
- Assist in identifying and remediating operational short-falls and researching and remediating claims
- Undergraduate degree
- 2+ years of provider relations and/or provider network experience
- Intermediate level of proficiency in claims research and issue resolution
- 1+ years of experience with Medicare and Medicaid regulations
- Master's degree
- Exceptional presentation, written, and verbal communication skills
- Ability to work independently and remain on task
- Strong 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
- Behavioral healthcare experience
Careers 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.(sm)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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: network, provider relations, provider, recruitment, New Orleans, LA, Louisiana, telecommute, remote, work from home