25 days old

Senior Provider Relations Advocate - Miami, FL - 925398

Miami, FL 33128
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  • Job Code
    925398

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)

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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 7 leader.

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Primary Responsibilities:

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  • Monthly performance visits to value-based groups to provide guidance with data, education, and training
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  • Coach, provide feedback and guide others
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  • Monitor groups performance, identify barriers, and create actions plans to improve process
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  • Assist in efforts to enhance ease of use of data within the ECG and Provider Portal Quality Reports
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  • Contribute to design and implementation of programs that build / nurture positive relationships between the health plan, providers, and practice managers
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  • Help implement training and development of external providers through education programs
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  • Coordinate quarterly Joint Operation Committee with group to review overall performance
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In this role, you'll be part of a performance driven, fast paced organization that is serving multiple markets. You'll have frequent interactions with senior management and physicians as you communicate about ways to evolve ongoing processes and programs.

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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.

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Required Qualifications:

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  • High school diploma
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  • 3+ years of health care / managed care experience
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  • 2+ years of provider relations and/or provider network experience
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  • 1+ years of experience with Medicare and Medicaid regulations
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  • Intermediate or higher level of proficiency in claims processing and issue resolution
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  • Intermediate or higher level of proficiency with MS Word, Excel, PowerPoint, and Access
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  • Bilingual (English & Spanish)
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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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  • Undergraduate degree
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  • General knowledge of HEDIS
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  • General knowledge of Medicare Risk Adjustment
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Careers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in health care. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.(sm)

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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.

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UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Job keyword: Senior Provider Relations Advocate, Provider Relations Advocate, Health Care, Managed Care, Provider Relations, Provider Network, Medicare, Medicaid, HEDIS, Medicare Risk, Claims, Bilingual, English, Spanish, Miami, FL, Florida

Posted: 2021-05-27 Expires: 2021-06-26

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Senior Provider Relations Advocate - Miami, FL - 925398

UnitedHealth Group
Miami, FL 33128

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