Sorry, this job is no longer accepting applications. See below for more jobs that match what you’re looking for!

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


  • 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

See if you are a match!

See how well your resume matches up to this job - upload your resume now.

Find your dream job anywhere
with the LiveCareer app.
Download the
LiveCareer app and find
your dream job anywhere

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Senior Application Development Engineer Schaumburg Or Chicago IL

U.S. Cellular

Posted 3 weeks ago

VIEW JOBS 10/22/2018 12:00:00 AM 2019-01-20T00:00 Senior Application Development Engineer - Schaumburg or Chicago, IL - ENG001159 The Sr Application Development Engineer supports the Applications Architecture, Applications Development best practices, and Applications Support and Operations. The role provides technical support to Project Management, Vendor Management, and internal business customer satisfaction. Interfaces with vendors for support of applications and technologies. Analyzes, integrates and maintains new or existing application components. Provide operational support of assigned technologies for the position. Participate in a cross-functional team to deliver solutions that span across the organization * Define technical requirements in support of budget plans and make recommendations for ways to improve performance and reduce costs. * Develop business cases that support changes to network and system infrastructure. * Provide technical support to customer-servicing infrastructure implementation projects; * Implements infrastructure changes. * Analyze network & system response and determine tuning recommendations to improve performance. * Collaborate with Project Management in the planning, design, engineering and drive the development, implementation, test and troubleshooting of infrastructure technologies on the customer-servicing network. * Perform advanced tier troubleshooting of 24x7 applications, including off-hour maintenance activities, problem resolution, and participation in rotational on-call support. * Design an effective test plan for any new / changed customer-servicing infrastructure. * Collaborate with partner organizations/departments to architect network or system solutions for our customer-servicing infrastructure * Documents procedures for business network operations. * Support identification and collection of metrics and performance reporting processes; I.e. Key Performance Indicators, SLA's and infrastructure standards. * Provide application development services around specific assigned technologies. * Leads the deployment of customer-servicing projects. * Identify process improvement areas and develop the improvement and automation initiatives. THE PRECEDING JOB DESCRIPTION INDICATES THE GENERAL NATURE AND ESSENTIAL DUTIES AND RESPONSIBILITIES OF WORK PERFORMED. IT DOES NOT CONTAIN A COMPREHENSIVE INVENTORY OF ALL DUTIES, RESPONSIBILITIES, AND QUALIFICATIONS REQUIRED TO DO THIS JOB. * Bachelor's degree in related discipline and 5 years work; or military experience or master's degree and 3 years years work or military experience. * Experience with ETL skills and fundamental understanding of data management systems including Big data and non-relational databases * Understanding of RESTful concepts * Good understanding of current technologies * Understanding of the business and industry * Experience re-engineering / process improvement * Strong experience running cross-functional project teams. * Excellent problem solving / analytical skills and knowledge of analytical tools * Excellent written and verbal communication skills. * Excellent presentation skills demonstrated in front of large audiences. * Experience supporting mission-critical infrastructure in a fast-paced environment * Experience working with Agile Development practices, i.e. Scrum/Kanban is prefered Job : Engineering Location(s) : Illinois-SCHAUMBURG_IL Illinois-CHICAGO_IL U.S. Cellular® is an EEO employer and gives consideration to qualified applicants without regard to race/color/age/religion/sex/sexual orientation/gender identity/national origin/disability/veteran status, pregnancy or genetic information. U.S. Cellular Schaumburg IL

Senior Provider Service Representative - Schaumburg, IL

Expired Job

Unitedhealth Group Inc.