You dream of a great career with a great company where you can make an impact and help people.We dream of giving you the opportunity to do just this.And with the incredible growth of our business, its a dream that definitely can come true. Already one of the worlds leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our Service Centers, improve our Service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.

This opportunity is with one of our most exciting business areas:Optuma growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader.

The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. ThisProvider Relations Advocaterole withUnitedHealth Groupwill call on your knowledge, your energy and your commitment to making health care work more effectively for more people. We're building better, more effective provider networks every day. In this role, 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 6 leader.

This role is aProvider Relations Advocatefor providers in the state of California.The incumbent must live inCalifornia, and preferably located in San Diego County.

If you are located in Southern California, you may have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities

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• Handling escalated provider claim and service issues and provider engagement activities that directly impact satisfaction and increase provider Net Promoter Score (NPS)
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• The position supports provider face to face engagement, education and training, including communications, live presentations, and information available to the provider network
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• Provider Medi-Cal trainings and ongoing education as guided by the State.Provider training timelines are aggressive and based on stringent regulatory turnaround time requirements
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• The position plays a central role that acts as the organizations network liaison between the provider network and critical customers including health plans
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• Establishment and collaboration of Medical Behavioral Initiatives jointly with health plans
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• The position is responsible for the ongoing monthly monitoring of participating providers managed care screening and enrollment process with the State, including follow up activities and regulatory mitigation efforts as a result of a participating providers disenrollment
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• The position supports the network analysis of the existing provider network to drive provider recruitment and gap remediation
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• Collaboration with internal contracting staff on provider recruitment and network development
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• 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
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• 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
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Are you ready for a challenge? You'll be part of a performance driven, fast paced organization that is serving multiple markets and you'll be charged with educating and building relationships with providers to evolve ongoing processes and programs.

Youll 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:

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• Bachelor's Degree or equivalent years of experience
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• 4+ years working in the California Market
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• 4+ year of experience using Microsoft Word, Excel, and PowerPoint
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• 3+ years of experience in a Network Management-related role, such as Provider Contracting and/or Provider Relations/Services
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• 3+ years of experience in performing network adequacy analysis
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• 3+ years of experience with Medi-Cal regulations
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• 3+ years of experience with Medicare regulations
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• 2+ years of experience using financial models and analysis to negotiate rates with providers
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• Intermediate level of knowledge of claims processing systems and guidelines
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• Excellent communication skills
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• 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 (i.e., entering your symptoms via phone system) or 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
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Preferred Qualifications:

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• Experience with Behavioral Health.
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• Excellent presentation skills.
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• Effective training skills
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Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Groups 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.

Job Keywords: Provider Relations Manager, Provider Relations Representative, growing business, behavioral health, Southern California, CA, California