Provider Relations Advocate, Government Plans - Palm Beach County, FL

Company: UnitedHealth Group
Location: Orlando
Posted on: June 24, 2022

Job Description:

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)

Serving one in five Medicare beneficiaries, UnitedHealthcare Medicare & Retirement is the largest business dedicated to the health and wellbeing needs of seniors and other Medicare beneficiaries. For more than three decades, UnitedHealthcare has served the health care coverage needs of Medicare beneficiaries, navigating through multiple evolutions of the Medicare program and growing to become the preferred choice of more beneficiaries than any other company. Today we remain committed to providing people with a choice of innovative health and well-being solutions that help them access the quality care they need and enjoy the superior experience they deserve. The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best.

**This is a non-exempt outside/field role**

This -M&R Provider Relations Advocate -role with UnitedHealth Group will 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 solid -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 5 -leader.

This team manages our care network to ensure we meet the needs of members and providers by driving high-quality care and patient outcomes. The team is responsible for assuring our individual, employer-sponsored, Medicare and Medicaid members have access to affordable, quality care delivered through a network of physicians, health care professionals, hospitals and other care facilities.

Our Provider Relations Advocates directly manage the on-going relationship with our providers. They provide training on new programs, issue resolution and support for our provider self-service support online tool Link. These Advocates leverage relationships across the company to ensure our providers receive high-quality service.

If you are located within Palm Beach -County FL, -you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

• 
  
• Travel to/meet with network providers within these FL counties
  
• Assist in end-to-end provider claims and help enhance call quality
  
• Assist in efforts to enhance ease of use of physician portal and future services enhancements
  
• Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers
  
• Support development and management of provider networks
  
• Help implement training and development of external providers through education programs
  
• Identify gaps in network composition and services to assist network contracting and development teams
  
• Manage provider directory management
  
• Optimize workflows, timelines, capacity
  
  
  Demonstrated Skills:
  
  
  • 
    
  • Ability to multi-task and work in a fast-paced environment
    
  • Excellent verbal and written communication skills
    
    
    You'll 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:
    
    
    • 
      
    • 2+ years of health and/or managed care experience
      
    • 1+ years of experience with Medicare and/or Medicaid regulations
      
    • Intermediate level proficiency in claims processing and issue resolution
      
    • Proficiency in MS Office (Outlook, Word, Excel, PowerPoint, Access)
      
    • Travel up to 75% of time within this Palm Beach County -network market area
      
    • Access to insured and reliable transportation that will enable you to travel to client and/or patient sites within a designated area
      
    • Have valid driver's license and good driving history
      
    • Live in/within commutable distance to -Palm Beach County, FL
      
    • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
      
      
      Preferred Qualifications:
      
      
      • 
        
      • Bachelor's or Master's degree
        
      • Provider relations and/or network management experience
        
      • Experience developing and maintaining credentialing policies and procedures
        
      • Bilingual Spanish
        
      • Experience working in a matrixed organization
        
        
        
        
        To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
        
        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)
        
        *All Telecommuters will be required to adhere to UnitedHealth Group's 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.

Keywords: UnitedHealth Group, Orlando , Provider Relations Advocate, Government Plans - Palm Beach County, FL, Government & Protective Services , Orlando, Florida