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Provider Engagement Manager

3 months ago

Orlando, Florida, United States UnitedHealth Group Full time

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Provider Engagement Manager is responsible for the full range of provider relations and service interactions within UnitedHealth Group, including training on the use of portal and future service enhancements, and training & development of external provider education programs. Managers of Provider Engagement design and implement programs to build and nurture positive relationships between the health plan and contracted providers (skilled nursing facilities, physician, hospital, ancillary, etc.). 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 assists in directing claims escalation issues to resolution.

If you are located in Florida , you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

  • 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)

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:

  • 5+ years of experience with Medicare and Medicaid regulations
  • 3+ years of provider relations and/or network management experience
  • 3+ years of supervisory experience
  • Expert level of knowledge of claims/systems processes, contracting and reimbursement methodologies
  • Expert level of proficiency with MS Word, Excel, and Access
  • Proven exceptional presentation, written and verbal communication skills

Preferred Qualifications:

  • Proven good organization and planning skills
  • Proven critical thinking skills and able to easily identify solutioning for business risks and opportunities
  • Proven ability to work independently and remain on task
  • Proven ability to prioritize and meet deadlines from multi-staff members within the department

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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.