Provider Engagement Rep – North Florida, Alabama, or Mississippi

Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual’s physical, mental and social needs – helping patients access and navigate care anytime and anywhere.

 

As a team member of our Senior Community Care (SCC) product, we work with a team to provide care to patients at home in a nursing home, assisted living for senior housing. This life-changing work adds a layer of support to improve access to care.

 

We’re connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together.

  

The Provider Engagement Representative is responsible for the full range of provider relations and service interactions within Optum, including working on end-to-end provider claim and call quality, and training & development of external provider education programs. Provider Relations Advocates design and implement programs to build and nurture positive relationships between the health plan, providers (physician, SNF, ancillary, etc.), and practice managers. Ensure Network deliverables in support of business development activities for new ISNP/IESNP implementations.

 

If you reside in North Florida, Alabama, or Mississippi, you’ll enjoy the flexibility to telecommute* as you take on some tough challenges.

 

Primary Responsibilities:

• Develop and maintain overall UnitedHealthcare business relationships with Skilled Nursing Facilities 
• Support all education opportunities on UnitedHealthcare businesses which include in person and telephonic interactions
• Lead and/or support external facing Account and business review meetings with key Skilled Nursing Facility staff
• Provide explanations and information to others on topics within area of expertise
• Prioritize and organize own work to meet deadlines cross functionally within the organization
• Investigate non-standard requests and issues, prior to escalation if needed
• Work exclusively within a specific knowledge area
• Salesforce Data Base – update & maintain regularly with information following AR, Bus Review and JOC Meetings with facilities
• Support Post-Acute Priorities
• ISNP Business Development – assist with planned growth initiatives for ISNP business
• Education and Training to facilities on Medication Adherence requirements for members
• Provide outreach and education on updated policies, new initiatives, performance, and others as necessary

 

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:

• 2+ years of provider relations and/or provider network experience
• 1+ years of experience with Medicare/Medicaid regulations
• Intermediate level of proficiency with MS Word, Excel, PowerPoint, and Teams
• Intermediate level of proficiency in claims processing and issue resolution
• Willing or ability to travel regionally up to 25%
• Reside in North Florida, Alabama, or Mississippi

 

Preferred Qualifications:

• Experience working in or with a Skilled Nursing 
• Experience with Salesforce/Compass databases
• Proven exceptional presentation, written and verbal communication skills
• Proven ability to prioritize and meet deadlines

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy  

 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

 

 

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.