Provider Relations Advocate

3 weeks ago

New York, United States UnitedHealth Group Full time

At UnitedHealthcare, we‘re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

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 Dental 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 strong 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 6 leader.

The Dental Provider Relations Advocate is responsible for the full range of provider relations and service interactions within UnitedHealth Group, including being the face of UnitedHealthcare (UHC) and Healthplex Dental in the field with our providers and the liaison for provider contracting questions, claim and call quality, ease of use of provider web portal, future service enhancements and training & development of provider education programs. The role may be involved in identifying and remediating operation short-falls and researching and resolving complex claims and claims issues. The role also ensures the network composition includes an appropriate distribution of provider specialties, including recruitment and contracting as needed. This role may involve Commercial, Medicare and Medicaid programs.

This position will cover an assigned territory within NY. The individual selected should live within NY. May consider candidates that are proximal to NY to allow for provider visitation.

If you reside within a commutable distance of New York state area, you‘ll enjoy the flexibility to work remotely * as you take on some tough challenges.

Primary Responsibilities:

  • This role will be a:
    • FQHC relationship owner
    • Provider relationship manager
    • Targeted Provider recruitment
    • Provider education
    • Provider at risk escalation resource
    • Member escalation contact
    • Network adequacy manager
    • Special project manager
    • Market expert

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:

  • 1+ years of experience in a network management related role, such as contracting, provider relations or provider services and/or experience working in a dental office
  • 1+ years of experience with Medicaid and Medicare reimbursement methodology (i.e. APG, PPS, FFS, Capitation)
  • Basic level of proficiency with MS Excel

Preferred Qualifications:

  • Knowledge of reimbursement methodologies
  • Provider contracting experience
  • Knowledge of Dental products/providers
  • Knowledge of claim processing systems and guidelines
  • Excellent verbal and written communication skills
  • Excellent time management skills
  • Excellent interpersonal skills, ability to establish rapport and work well with others
  • Customer service skills
  • Reliable transportation
  • Reside in service area as noted above

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

New York Residents Only: The salary range for this role is $58,300 to $114,300 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you‘ll find a far-reaching choice of benefits and incentives.

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.

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