Requisition number: 2365745
Job category: Network Management
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together
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 solid 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.
Positions in this function are accountable for the full range of provider relations and service interactions within UHG, including working on end-to-end provider claim, ease of use of physician portal and future service enhancements, and training & development of external provider education programs. Designs and implements programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Directs 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 needs. May also be involved in identifying and remediating operational short-falls and researching and remediating claims. Generally, work is self-directed and not prescribed.
This is a field-based role with frequent on-site visits and meetings with physician groups or hospital systems.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Assist in end-to-end provider claims
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
Work with less structured, more complex issues
Serve as a resource to others
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
5+ years of health care and/or managed care experience
3+ years of provider relations and/or provider network experience
1+ years of experience with Medicare or Medicaid regulations
Experience working directly with physician groups or hospital systems in the provider community
Intermediate level of proficiency in claims processing and issue resolution
Intermediate proficiency with MS Word, Excel, PowerPoint
Willing and able to travel up to 25%
Willing and able to work Pacific Coast Hours
Preferred Qualifications:
Experience with hospital and ancillary claims
Proven excellent presentation skills with experience and comfortability presenting to others
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.