Provider Relations Advocate - Whatcom, Skagit Or Snohomish County

Unitedhealth Group Inc. Seattle , WA 98113

Posted 4 weeks ago

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, specifically skilled nursing facilities and primary care 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 Whatcom County or Skagit County or Snohomish County, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Assist in end-to-end provider claims and help enhance call quality

  • 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 (SNFs), 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

Are you ready for the next step? You'll be part of a performance driven, fast paced organization that is serving multiple markets and you'll be charged with educating and building relationships with providers 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:

  • Undergraduate degree or equivalent work experience

  • 4 years of health care / managed care experience

  • 2 years of provider relations and / or provider network experience

  • 1 years of experience with Medicare, Medicaid, and commercial regulations

  • At least an intermediate level of proficiency with MS Word, Excel, and PowerPoint

  • Ability to travel within local market up to 50%

Preferred Qualifications:

  • Prior experience with internal systems such as ISET, COSMOS, CSP Facets and / or NDB

  • Experience with claims processing and issue resolution

  • Experience with giving presentations

  • Network contracting experience

  • Previous experience working in / with skilled nursing facilities

  • Previous experience with medical billing / coding

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 with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: health care, healthcare, provider relations, provider network, network management, claims, contracting, Medicaid, Medicare, commercial, skilled nursing facilities, SNF, Seattle, Washington, WA


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Provider Relations Advocate - Whatcom, Skagit Or Snohomish County

Unitedhealth Group Inc.