Physician Business Manager / Provider Relations – Harlingen, TX

Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together.  

Are you ready for a challenge? 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.

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 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
• Analyze outcomes and make appropriate recommendations to improve outcomes / processes moving forward
• Collect / synthesize best practices from across a network of provider organizations
• Build and sustain positive provider relationships
• Meet and / or exceed client service level provider relations expectations
• Manage provider relationships that require frequent contact; includes large, regional and complex clients

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 health care / managed care experience
• 2+ years in healthcare provider relations, provider network management, medical office administration, revenue cycle management, or Medicare Advantage sales
• Proficiency with MS Word, Excel
• Ability to travel locally within the region about 25-50%
• Access to reliable transportation

Preferred Qualifications:

• Proficiency in claims processing and issue resolution
• Experience with Medicare regulations

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.