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 6 leader.
Directly responsible for all provider services functions in the local market place representing the organization and functioning as a key member of the local field office. Working directly with the local Executive Directors to add maximum value to the IPA physicians.
- Directly responsible for working with IPA physicians to ensure provider satisfaction in accordance with the IPA standards
- Directly responsible for working with the designated health plan representatives on local issues and concerns (including directory accuracy)
- Directly responsible for all physician education including distribution of key IPA documentation and policies and procedures and orientations
- Directly responsible for education of physician’s management staff and performs regularly scheduled Office Manager’s meetings
- Responsible for ensuring network compliance with regulatory requirements including but not limited to accessibility and availability of required specialties
- Responsible for understanding local market dynamics performing routine market analysis and organizing appropriate marketing and promotional activities
- Responsible for ensuring network is maximized based on market analysis and that there are no network gaps, including identification of new providers
- Responsible for optimizing electronic connectivity between the providers and NAMM operations to ensure economical transaction management
- Manage provider contracts deemed appropriate by the Executive Director
- Bachelor’s degree in communication-related field or equivalent experience
- 5-7 years health care marketing/provider
- Computer literate in word and excel. Access and power point experience preferred
- Excellent written and verbal language skills
- Ability to work independently, organizing and prioritizing work flow
- Ability to effectively present information and respond to questions from physicians, clients, customers and the general public
- Strong organizational and communication skills. Adept at problem solving
- Working knowledge of ICD-9, CPT and HCPCS coding
- Proficient at managing multiple tasks and priorities
- Able to construct and interpret contract language/terms
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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
North American Medical Management, California, Inc (NAMM California) partnered with OptumHealth in 2012. NAMM California and OptumHealth share a common goal of bringing patients, physicians, hospitals and payers closer together in the mission to increase the quality, efficiency and affordability of care. NAMM California is a part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system. NAMM California develops and managers provider networks, offering a full range of services to assist physicians and other providers in supporting patient care coordination and their managed care business operations. For over 18 years, NAMM California has been an innovator in health care with a track record for quality, financial stability, extraordinary services and integrated medical management programs. NAMM California is well positioned to continually invest in its infrastructure and systems for the benefit of its provider clients and to accommodate the impending changes that will come forth from healthcare reform.
The NAMM California provider clients represent a network of almost 600 primary care physicians and over 3,000 specialists and work with the premier hospitals in their respective markets.
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, ICD-9, CPT, HCPCS, Healthcare, Palm Desert, CA, California