There are changes happening in health care that go beyond the basics we hear in the news. People like you and organizations like UnitedHealth Group are driving ever higher levels of sophistication in how provider networks are formed and operate. The goal is to improve quality of service while exploring new ways to manage costs. Here's where you come in. 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 6 leader.
If you are located within Western PA, you will have the flexibility to telecommute* as you take on some tough challenges.
- Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers
- Assist in end-to-end provider claims and help enhance call quality
- Help implement training and development of external providers through education programs
- Assist in efforts to enhance ease of use of physician portal and future services enhancements
- Identify gaps in network composition and services
In this role, you'll be part of a performance driven, fast paced organization that is serving multiple markets. You'll have frequent interactions with senior management and physicians as you communicate about ways to evolve ongoing processes and programs.
- 4+ years of health care/managed care experience
- 2+ years of provider relations and/or provider network experience
- Intermediate level of proficiency in claims processing and issue resolution
- 1+ years experience with Medicare and Medicaid regulations
- Proficiency with MS Word, Excel, PowerPoint
- Up to 50% local travel to Western PA for provider visits required
- 2+ years of experience in claims processing / issue resolution
- Experience with UHG systems NDB, UNET, COSMOS, FACETS, PhyCon, Emptoris
- Presentation Experience
- Knowledge of the Western PA market
- Customer service focus
- Undergraduate or higher level degree
The health system is moving ahead. You can too as you help us build new levels of provider network performance. Join us. Learn more about how you can start doing your life's best work.(sm)
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)
*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: Sr. Provider Relations Advocate,Provider Relationships, Provider Education, Western Pennsylvania Provider Relations, Provider Education