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Senior Provider Service Representative - Schaumburg, IL

Expired Job

Unitedhealth Group Inc. Schaumburg , IL 60196

Posted 3 months ago

Energizeyour career with one of Healthcare's fastest growing companies.

Youdream of a great career with a great company where you can make an impact andhelp people. We dream of giving you theopportunity to do just this. And withthe incredible growth of our business, it's a dream that definitely can cometrue. Already one of the world's leading Healthcare companies, UnitedHealthGroup is restlessly pursuing new ways to operate our service centers, improveour service levels and help people lead healthier lives. We live for the opportunity to make adifference and right now, we are living it up.

Thisopportunity is with one of our most exciting business areas: Optum a growingpart of our family of companies that make UnitedHealth Group a Fortune 6 leader.

Optum helps nearly 60million Americans live their lives to the fullest by educating them about theirsymptoms, conditions and treatments; helping them to navigate the system,finance their healthcare needs and stay on track with their health goals. Noother business touches so many lives in such a positive way. And we do it allwith every action focused on our shared values of Integrity, Compassion,Relationships, Innovation & Performance.

Challenge can often be its own reward. But why settle for just being challenged when you can also be nurtured, mentored and supported in building an impactful and fast paced career? With UnitedHealth Group you can have all of the above every day. UnitedHealth Group is driving even 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 knowledge of insurance claims and customer service to help create strong relationships with the providers in our networks. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 6 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 and call quality, 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. Employees in jobs labeled with SCA must support a government Service Contract Act (SCA) agreement.

Primary Responsibilities:

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

  • Assist in the design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers

  • Act as a technical resource to others

  • 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

  • Ensure provider service quality by working with them to resolve issues, deliver educational materials and contribute to projects that enhance overall operational effectiveness

  • Extensive work experience within own function

  • Work is frequently completed without established procedures

  • Works independently

  • May act as a resource for others

  • May coordinate others' activities

Required Qualifications:

  • High School Diploma / GED (or higher)
  • 1 years of experience in a Pharmacy or PBM environment
  • 2 years of experience using Rx Claims System
  • 2 years of experience opening, creating, saving, and sending emails, and folders within Microsoft Outlook
  • 1 years of experience creating, entering, sorting, and reading data in a Microsoft Access Database

Asset:

  • 2 years Experience in a Pharmacy or PBM environment

OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do.

If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable healthcare solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance. Join us and start doing your life's best work.

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.

Keywords: Microsoft Office, Claims RX, Customer Service, Research, Claims


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Senior Provider Service Representative - Schaumburg, IL

Expired Job

Unitedhealth Group Inc.