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 5 leader.
If you are located in the Western Massachusetts, you will have the flexibility to telecommute* as you take on some tough challenges.
- Assist in end-to-end provider claims and help enhance call quality
- Coach, provide feedback and guide others
- Assist in efforts to enhance ease of use of physician portal and future services enhancements
- Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers
- Help implement training and development of external providers through education programs
- Identify gaps in network composition and services to assist network contracting and development teams
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.
- High school diploma or equivalent experience
- 5+ years of health care/managed care experience
- 3+ 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 and Access
- Undergraduate 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 at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place 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: Provider Relations, Aging Services Access Points (ASAPs) community providers. Fiscal Intermediaries, Framingham, Worcester, Milford, Westborough, Hopkinton