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
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