Requisition number: 2392215

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 in making healthcare work better for everyone through people-led, responsible AI while 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 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 7 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.

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

• In this role, you'll be part of a performance driven, fast paced organization that serves multiple markets. You'll have frequent interactions with senior management and physicians as you communicate about ways to evolve ongoing processes and programs.

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 3+ 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 Mountain Time Hours

Preferred Qualifications:

• Experience with hospital, physician, ancillary claims and RHC / FQHCs

• 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 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are 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 and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.