Provider Relations Representative – Remote in Colorado

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The C&S Colorado Provider Relations Representative is responsible for resolving, or coordinating the resolution of, complex provider concerns either via the telephone, email, or occasionally by visiting the provider office. Responsible for providing advanced administrative and technical services that support the provider relations team.

This role that will require up to 10% travel throughout the Western and Southern Colorado area.

If you are located in Colorado, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Work collaboratively with other provider network staff and various internal and external resources to respond to a variety of complex inquiries related to provider issues. Triage the inquiry and provide resolution or defer to the appropriate resource. Serve as a resource for other internal business units or employees working with provider issues. Maintains comprehensive log of inquiries and visits
• Respect confidentiality and maintain confidences as described in the UHG Employee Handbook and acknowledged through signature by all employees. The ability to maintain confidentiality is a critical and essential component of this position
• Receive, research, and process provider questions and issues as assigned. Process complaints according to the provider complaint administrative denial process and related regulations. Resolve or coordinate the resolution as appropriate. Communicate results back to originating provider. Track results and identify trends as directed. Provide training to guidance to providers regarding UHC systems and processes as necessary
• Use excellent interpersonal and communication skills, professional demeanor, tact, systems thinking, and a commitment to quality to assist in the resolution of sensitive and complex health plan issues primarily via the telephone, email, and occasionally in person
• Responsible for providing the administrative and technical services necessary to support the provider relations team. Support may include but is not limited to claims and appeals research, providing data used in audits, submitting provider database corrections or changes, validating data for use in directories or fee schedules, and occasionally providing support for individual and group contracting 
• This position may require/requires travel. Requires independent, reliable, flexible, and on-demand, transportation at the incumbent’s expense for travel between various locations and timely arrival and departure from various locations. If the employee chooses to satisfy this requirement by driving a vehicle, the employee must meet the requirements for Colorado licensure and company requirements for liability insurance coverage

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:

Requires the combination of education and experience that would enable performance of the full scope of the position

• 2+ years of experience with technical health plan processes, such as claims processing and benefits administration
• 2+ years of relationship management experience, preferably in a healthcare setting
• Experience and basic proficiency with common programs such as Microsoft Word and Excel
• Demonstrated ability to manage complex business relationships

Preferred Qualifications:

• 2+ years of related progressive experience in a managed care environment
• Excellent written and verbal communication skills

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

 

The salary range for this role is $59,500 to $116,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

 

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.