Senior Provider Relations Advocate - Remote MST

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

This role is a Senior Provider Relations Advocate for providers in MST time zone. The incumbent must live in MST time zone.

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

Primary Responsibilities:

• Managing escalated provider claim and service issues and provider engagement activities that directly impact satisfaction and increase provider Net Promoter Score (NPS)
• The position supports face to face engagement, education, and training, including communications, live presentations, and information available to the provider network
• Provider training and ongoing education as guided by the State. Provider training timelines are aggressive and based on stringent regulatory turnaround time requirements
• The position plays a significant role that acts as the organization's network liaison between the provider network and critical customers including health plans
• Establishment and collaboration of Medical Behavioral Initiatives jointly with health plans
• The position is responsible for the ongoing monthly monitoring of participating provider's managed care screening and enrollment process with the State, including follow-up activities and regulatory mitigation efforts because of participating provider's disenrollment
• The position supports the network analysis of the existing provider network to drive provider recruitment and gap remediation
• Collaboration with internal contracting staff on provider recruitment and network development
• Involvement in regulatory responses to network shortfalls, including provider outreach and education. Provider Relation Advocates are required to respond and remediate any concerns or issues that are a result of the audits and implement corrective actions plans as needed
• Due to the nuances of health plan and county stakeholders, provider networks, and various geographic considerations in each county across the state, Provider Relation Advocates are expected to work in or in proximity of the service area (county) and be familiar with that market

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:

• 3+ years of experience using Microsoft Word, Excel, and PowerPoint 
• 3+ years of experience in a Network Management-related role, such as Provider Contracting and/or Provider Relations/Services
• 3+ years of experience with claims processing systems and guidelines
• 3+ years of experience in performing network adequacy analysis
• 3+ years of experience with Medicaid regulations

• 2+ years of experience using financial models and analysis to negotiate rates with providers

Preferred Qualifications:

• Experience with Behavioral Health
• Proven excellent presentation skills
• Proven excellent communication skills
• Proven effective training skills

*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 $72,800 to $130,000 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.