Job Description

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

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.

The Provider Relations Advocate is responsible for the full range of provider relations and service interactions within UnitedHealth Group, including working on end-to-end provider claim issues, ease of use of physician portal and future service enhancements, and training & development of external provider education programs. Senior Provider Relations Advocates design and implement programs to build and nurture positive relationships between the health plan, physician providers and practice managers. Responsibilities also include involvement in identifying and remediating operational short-falls and researching and remediating claims. 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.

If you are located in Oklahoma City, Tulsa, or Woodward, OK, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

* Build and nurture positive relationships between the health plan, providers and practice managers
* Manage provider relationships that require frequent contact; includes large, regional and complex clients
* Assess and interpret customer needs and requirements
* Solve moderately complex problems and/or conduct moderately complex analyses
* Drive resolution and engage internal staff for results
* Identify solutions to non-standard requests and problems
* Provide explanations and information to others on difficult issues
* Assist in end-to-end provider claim resolution
* Enhance provider interaction quality
* Expertise in physician contract reimbursement methodologies
* Act as a resource for others with less experience
* Coach, provide feedback and guide others
* Assist in efforts to enhance ease of use of physician portal and future service 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
* Create and present PowerPoint provider education decks
* Identify gaps in network composition and services to assist network contracting and development teams
* Position requires some travel (10-15%) to meet with providers, make presentations, attend Expos

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

* 3+ years of health care/managed care experience
* 3+ years of provider relations and/or provider network experience
* 1+ years of experience with Medicare and Medicaid regulations
* Intermediate level of proficiency in claims processing and issue resolution
* Ability to prioritize and meet deadlines from multiple large provider groups
* Expertise in physician contract reimbursement methodologies
* Intermediate knowledge of commercial product lines of business
* Ability to work independently and remain on task
* Intermediate proficiency with MS Word, Excel, PowerPoint and Access
* You will be provisioned with appropriate Personal Protective Equipment (PPE) and are required to perform this role with patients and members on site, as this is an essential function of this role
* Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained

Preferred Qualifications

* Undergraduate degree or higher
* Internal advocate experience
* Experience working with Federally Qualified Health Clinics (FQHC), Rural Health Clinics (RHC) and/or Indian Health Clinics (IHC)
* Experience with CSP-FACETS
* Experience with Oklahoma Medicaid
* Experience with Salesforce
* Good organization and planning skills
* Exceptional presentation, written and verbal communication skills

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 Services, Physician Practice, Provider Relations Advocate, Provider Relations, Provider Advocate, Practice Performance Manager, Provider Data Analyst, Telecommute, Telecommuting, Telecommuter, Work From Home, Remote, Oklahoma City, Tulsa, Oklahoma City, Woodward, Oklahoma, OK