Provider Relations Advocate, Vision - Work from Home in CST or EST

UnitedHealth Group Inc.
Columbia, MD
Jul 31, 2021
Aug 04, 2021
Accountant, IT
Full Time
UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) 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's where you come in. You'll use your strong customer service orientation and knowledge of insurance claims to serve as an advocate for providers in our networks. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 5 leader. As a Provider Relations Advocate for UHC Vision, you will have overall responsibility for the provider relationship management for the commercial and government (Medicare and Medicaid) product lines. If you are located in CST or EST time zones, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: * Accountable for resolution of escalated issues related to network providers and enhancing provider experience, measured by NPS * Support initiatives to manage network costs * Accountable for execution of provider training and education programs * Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers * Recommend improvements in processes * Finalize recruitment and contracting effort in order to fulfill credentialing requirements * Provide assistance regarding provider education, contract questions, and claim issues * Collect and ensure the quality and integrity of data in the provider data systems * Performs audits of accounts that can be used for internal and/or external discussions * Monitor and track provider issues through calls, emails, and other avenues * Other duties as assigned in support of department goals and objectives 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: * High school diploma or GED * 5+ years of health care/managed care experience * 3+ years of provider relations and/or provider network experience * 1+ year of experience in claims processing and issue resolution * 1+ year of experience with Medicare and Medicaid regulations * Proficiency with MS Word, Excel and PowerPoint * If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (ie, entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas, In addition, employees must comply with any state and local masking orders Preferred Qualifications: * Undergraduate degree * Optical/Vision industry experience UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us. You can learn more about all we are doing to fight COVID-19 and support impacted communities: click here. * All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. 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. 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