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)

The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This Provider Relations Advocate role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. We're building better, more effective provider networks every day. In this role, 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.

If you reside in the state of Hawaii, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

* Assist in end-to-end provider claims processing and resolution
* Local market presence; Relationship Manager
* Front Line Account Management resolving provider issues
* Assist in efforts to enhance ease of use of provider portal and future services enhancements
* Help implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers
* Support development and management of provider networks
* 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
* Act as the liaison between the provider, client and members
* Handling high level escalations
* Be able to manage workload automatously and meet goals and deadlines
* Travel within assigned territory will be required

In this role, you'll be part of a performance driven, fast paced organization that is serving multiple markets and you will have frequent interaction with providers as you educate and focus on building relationships 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 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:

* High school diploma or GED
* 1+ years insurance claims experience
* 1+ years of Medicaid experience
* 1+ years of experience providing training or education
* Intermediate or higher level of proficiency with MS Outlook
* Ability to travel up to 50% of the time within the State of Hawaii
* If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:

* Experience with CSP Facets
* Provider Advocate experience
* HI Medicaid experience
* Knowledge of Medicaid Regulations
* Dental industry knowledge
* Dental Treatment Plan Coordinator/Dental Office Manager
* Claims processing and issue resolution knowledge and experience
* Intermediate or higher level of proficiency with MS Word, Excel and PowerPoint
* Excellent written and oral communication
* Ability to work independently and remain on task with little to no day to day supervision
* Good organization, planning skills
* Ability to prioritize and meet deadlines from multiple staff members throughout the department

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 Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is 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, Provider Advocate, HCBS, Home And Community Based Services, Claims Resolution, Hawaii, Medicaid, Telecommute, Telecommuting, Telecommuter, Work From Home, Remote, Honolulu, Hawaii, HI