Sr Provider Relations Advocate - Reside in NYC Area

Company: UnitedHealth Group
Location: Houston
Posted on: June 25, 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) The Sr Provider Relations Advocate role leverages your solid customer service and health care claim experience to resolve challenges for our national network providers. - In this professional role, a self-directed individual will serve as the point of contact to take in and resolve complex operational issues and proactively educate providers on new products and programs. - As the single point of contact, you will bring actionable data and tools to assist providers with achieving their organizations business goals, as well as anticipate challenges their organization might face, and identify solutions across UHG's dynamic and matrixed organization representing UHC's top revenue generating contracts. - This role will develop and execute engagement strategies to support UHG initiatives and identify and collaborate with key stakeholders of our largest providers. - If you are located in -White Plains, NY, -you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities:

• Primary responsibility for managing Strategic and Core Health systems and Hospital Based providers across multiple lines of business
• Success will be supported by your ability to constantly build upon your own experience and understanding of the enterprise
• Where Standard Operating Procedures (SOP) guidelines may not exist or are limited in scope, it will require a high degree of resilience and persistence to provide root-cause analysis, see tasks through to resolution, identify trends, implement solutions and education the provider on outcomes
• Possess an inherent ability to problem-solve complex and novel issues that may not have a clear path to resolution
• Triage and determine root cause through researching data and claims systems for all Lines of Business for escalated claims issues impacting a provider's Accounts Receivable, including capitated requirements. - Where applicable, determine broader impact of identified root cause beyond the provider where the topic was initiated
• Engages with enterprise business partners to identify common billing practices and education provider to reduce office administrative burden and increase operating efficiencies
• Communicate with and education providers on outcomes of root cause analyses, including proposed actions for the provider to improve their revenue cycle experience
• Provider education may be provided in -person, telephonic and/or web-based interactions
• Coordination and independently leading monthly Operational meetings with Strategic and Core assigned providers. - This includes the coordination of the meeting, creating agendas, facilitating, sending out meeting minutes and tracking open/closed items
• Proven ability to assess and interpret customer needs and requirements
• Manage provider issue tracking logs and track to completion
• Demonstrate as an expert and become a trusted advisor for assigned Provider Accounts through demonstration of our Cultural Values: Integrity, Compassion, Relationships, Innovation, and Performance
• Position requires travel to meet with providers to support on-site meetings and educational needs
• Ability to prioritize work and be flexible to change
• Solid self-management skills, and an affinity for continuous learning 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:
  • Undergraduate degree in Health Administration, Business or equivalent combination of education and relevant experience
  • 5+ years of experience in health plans or provider experience, with a demonstrated focus on training, education, and/or revenue cycle work
  • 2+ years of project management experience with the ability to coordinate/schedule, independently facility Monthly Operational meetings with assigned providers, including creating agendas, taking meeting minutes and sending out summaries
  • 2+ years of experience working with ISET, CSP Facets, NDB and IMPACT
  • Proficiency with MS Office suite, SharePoint, and customer management software
  • Proven ability to prioritize tasks and work independently and effectively under time constraints
  • Basic knowledge of CPT and ICD-10 coding
  • Integrated knowledge of UHC Data and Claims Platforms with an understanding of complex provider data record setup to enable identification of potential issues Preferred Qualifications:
    • Experience in provider billing capacity, claims level audit, recovery operations experience with claims data knowledge
    • Ability to work within multiple complex technology and enterprise-wide systems
    • Experience with claims platforms or healthcare platforms
    • Experience working in a capitated/delegated or shared risk environment
    • Experience managing, coordinating and/or explaining complex capitated-delegated processes including cap-deductions and explanations
    • Reside in Southern New York State
    • Solid customer service skills with critical thinking skills and confidence to evaluate and develop solutions
    • Solid analytical, critical reasoning and organizational skills
    • Excellent verbal and written communication skills with the ability to communicate effectively with external providers
    • Solid interpersonal skills, establishing rapport and working well with internal partners
    • 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 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 with UnitedHealthcare. -Let's talk about opportunity. Start with a Fortune 5 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) *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, Houston , Sr Provider Relations Advocate - Reside in NYC Area, Other , Houston, Texas