Manager Provider Relations Service Advocacy – Remote in WA

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.  

 

It’s a big step forward when you realize that you’ve earned the trust to lead a team. Now, let’s determine just how big that step can be. Take on this managerial role with UnitedHealth Group and you’ll be part of a team that’s reshaping how health care works for millions. We’re driving ever higher levels of sophistication in how provider networks are formed and operated. The goal is to improve the quality of service while exploring new ways to manage costs. Here’s where you come in. 

 

You’ll use your solid customer service and leadership skills to ensure quality of interactions and performance of providers in our networks. As you do, you’ll discover the resources, backing and opportunities that you’d expect from a Fortune 5 leader.

 

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

 

Primary Responsibilities: 

• Participate in company initiatives related to compliance or advocating company resources
• Communicate and advocate providers’ needs to internal stakeholders to drive creation of solutions that meet our mutual business goals
• Develop and implement protocols ensuring provider trends/issues are resolved/communicated in a manner that is easy to comprehend 
• Work with internal groups to identify, understand, and/or improve internal tools, resources, systems, and capabilities that can maximize provider, member, or company performance
• Educate providers on policies and procedures applicable to delivery of care (e.g., regulatory; benefit; claims) through various means (e.g., e-mail; outreach calls; and scheduled virtual and on-site meetings)
• Gather data from relevant systems (e.g., claims; data warehouse; payment integrity; EDI/Portal reporting; customer relations systems) and business partners (e.g., contracting; claims operations)
• Analyze data to determine root cause of issue (e.g., identify trends and patterns; identify outliers and anomalies) and/or escalate problems to appropriate group for further analysis as necessary
• Coordinate with internal and/or external resources to implement provider solutions with a focus on reducing provider account receivables
• Assist and support team in their research on provider issues
• Manage inventory for aligned markets, including any escalations
• Host and facilitate calls with providers and staff
• Manage self and team MBOs/goals
• Conduct development activities with team
• Become a resource for stakeholders for assigned markets
• Understand nuances of contracted providers in aligned markets
• Comfortable in self-sufficiency of issue resolution and guiding team in complex issues that do not have a standard workflow 

 

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: 

• 5+ years issue resolution experience
• 3+ years of provider relations experience
• 2+ years of provider billing policies and procedures experience
• 1+ years of leadership experience
• Intermediate or better level of knowledge of claims processing
• Provider contracting/credentialing knowledge
• Proficiency in MS Word, PowerPoint, Excel and Access
• Proven exceptional presentation, written and verbal communication skills
• Will need to reside in the state of Washington
• Willing and able to travel up to 25% nationally

 

Preferred Qualifications:

• Leadership/Supervisory experience
• Call or claim adjudication experience

 

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

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable. 

 

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.