Provider Relations Manager – TN or AL – Remote

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 naviHealth product, we help change the way health care is delivered from hospital to home supporting patients transitioning across care settings. This life-changing work helps give older adults more days at home.

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

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 is where you come in. You will use your solid customer service orientation and knowledge of insurance claims to serve as an advocate for providers in our networks. As you do, you will discover the impact you want and the resources, backing and opportunities that you would expect from a Fortune 4 leader.

A highly engaged provider network is critical to ensure members receive the right care at the right place for the right amount of time. The Provider Relations Manager develops and maintains an ongoing collaborative relationship with providers, based on mutual respect, high-quality outcomes, and patient satisfaction. The role works to continually shape the network landscape, by offering objective data and education to all stakeholders in the market. In its highest functional state, it is the Provider Relations Manager who supports the provider in ensuring recognition by the hospital and plan partners through appropriate application of best practices in quality, efficiency, and process management. The market for this role is Tennessee, Alabama, Mississippi, and Louisiana.

Why naviHealth?

At naviHealth, our mission is to work with extraordinarily talented people who are committed to making a positive and powerful impact on society by transforming health care. naviHealth is the result of almost two decades of dedicated visionary leaders and innovative organizations challenging the status quo for care transition solutions. We do health care differently and we are changing health care one patient at a time. Moreover, have a genuine passion and energy to grow within an aggressive and fun environment, using the latest technologies in alignment with the company’s technical vision and strategy.

If you are located in Tennessee, Alabama, Mississippi or Louisiana, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Develop relationships with providers/payers and support the patient-centric model during new implementations
• Maintain positive working relationships with providers/payers to build a high quality, highly receptive network base in mature markets
• Lead network issue resolution
• Deliver ongoing analytics and support materials for providers
• Work closely with market presidents and senior clinical managers to monitor and improve hospital DC referral patterns, par and non-par home health agencies, and closed record statistics
• Collaborate closely with provider relations leadership
• Coach, provide feedback and guide others
• Assist in efforts to enhance ease of use of provider portal and future services enhancements
• Contribute to design and implementation of programs that build/nurture positive patient and provider experiences
• 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

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:

• Healthcare experience
• 3+ years of experience collaborating with providers or related account management roles
• Driver’s License and access to a reliable transportation

Preferred Qualifications:

• Clinical licensure – RN, PT, OT, or ST
• 5+ years of health care/managed care experience
• 3+ years of provider relations and/or provider network experience
• Experience across the acute and post-acute care continuum
• Proficiency in claims processing and issue resolution
• Proficiency with MS Word, Excel, PowerPoint, and Access

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

The salary range for this role is $71,600 to $140,600 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.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. 

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.