[Hiring] Senior Provider Relations Advocate @UnitedHealth Group

Role Description

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.

• 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.

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.

Requirements

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

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase.
• 401k contribution (all benefits are subject to eligibility requirements).