[Hiring] Provider Relations Advocate @UnitedHealth Group

Role Description

The Provider Relations Advocate will maintain a successful working relationship between Optum Serve and network providers through a full range of provider relations and service interactions to ensure provider retention.

• Identify and remediate operational shortfalls.
• Respond to customer complaints, customer satisfaction surveys, and provider questions.
• Research and resolve accounts payable issues.
• Negotiate cost-effective fees for single services.
• Confirm service capability and educate providers on contract expectations, processes, and paperwork.
• Evaluate and analyze beneficial solutions for Optum Serve and network providers.

Qualifications

• High School Diploma/GED.
• 1+ years of experience in provider relations.
• 1+ years of computer proficiency experience with Microsoft Office (Word, Excel, and Outlook).
• Access to a designated quiet workspace in your home with the ability to secure Protected Health Information (PHI).
• Live in a location that can receive a UnitedHealth Group approved high-speed internet connection.
• Ability to work an 8-hour shift between 8:00 am - 6:00 pm Monday through Friday based upon business needs.
• Access to reliable transportation and a current and non-restricted state driver’s license.
• Ability to travel 10% of the time within 100 miles of territory assigned.

Requirements

• Assess and resolve specific provider concerns, developing and implementing beneficial solutions.
• Educate providers on fee structures to ensure collaborative agreement and understanding of LHI Services.
• Staff Provider Relations Telephone Queue and respond to incoming calls appropriately.
• Respond to Customer Satisfaction Surveys and Customer Complaints within the required time frame.
• Provide explanations and information on topics within area of expertise.
• Proactively review and maintain provider compliance documents.
• Collaborate with other departments to assign qualified providers to orders.
• Assist in complex end-to-end provider claims processing and resolution.
• Resolve complex complaints within strict deadlines while ensuring accuracy and compliance.
• Assist in enhancing ease of use of physician portal and future services enhancements.
• Identify gaps in network composition and services.
• Utilize relevant data to analyze and resolve issues.
• Manage and prioritize work effectively to meet deadlines.
• Coordinate meetings with providers to discuss various topics.
• Attend and contribute to multi-department meetings.
• Perform other duties as assigned.

Benefits

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays.
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account.
• Dental, Vision, Life & AD&D Insurance along with Short-term and Long-Term Disability coverage.
• 401(k) Savings Plan, Employee Stock Purchase Plan.
• Education Reimbursement.
• Employee Discounts.
• Employee Assistance Program.
• Employee Referral Bonus Program.
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.).