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Manager Provider Relations Service Advocacy-Connecticut, Rhode Island, Massachusetts - 727803
at UnitedHealth Group
Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)
The Manager of Provider Relations Service & Advocacy is responsible for the full range of provider relations and service interactions within UnitedHealth Group, including working on end-to-end provider claim and call quality, ease of use of provider portal and future service enhancements, and training & development of external provider education programs. Managers of Provider Relations Service & Advocacy design and implement programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Responsibilities also include directing and implementing strategies relating to the development and management of a provider network, identifying gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs, and may also be involved in identifying and remediating operational short-falls and researching and remediating claims.
Set team direction, resolve problems and provide guidance to members of own team
May oversee work activities of other supervisors
Adapt departmental plans and priorities to address business and operational challenges
Influence or provide input to forecasting and planning activities
Product, service or process decisions are most likely to impact multiple groups of employees and / or customers (internal or external)
- Undergraduate degree or 5 years of equivalent experience
5+ years of provider relations and / or network management experience
Expert level of knowledge of claims / systems processes, contracting and reimbursement methodologies
Exceptional presentation, written and verbal communication skills
Ability to work independently and remain on task
Good organization and planning skills
Ability to prioritize and meet deadlines from multi - staff members within the department
Expert level of proficiency with MS Word, Excel, and Access
- Travel 25% in New England States
- Must reside in MA, CT, or RI
- 3+ years of management experience
5+ years of experience with Medicare and Medicaid regulations
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SM
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, network management, Shelton, CT, Connecticut, Massachusetts, Rhode Island