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Provider Relations Representative

3 months ago

Oxnard, United States Optum 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 Relations Representative** is responsible for establishing and maintaining positive relationships with various clients building strong, cohesive business partnerships. Works with internal staff, client representatives, and other contracted entities to deliver contractual performance standards and ensure customer service objectives are continually met.

The Provider Relations Representative must have the ability to handle various situations in a professional manner, demonstrating excellent customer service at all times and ability to adapt to change. Must be able to work collaboratively with multiple internal departments as well as external organizations. Willingness to work as part of a team, working with others to achieve goals, solve problems, and meet established organizational objectives.

**Location**: 1901 Solar Dr. Ste 200 Oxnard, CA 93036

**Hours**: Monday through Friday from 8am-5pm PST

If you reside near Oxnard, CA, you will enjoy the flexibility of a hybrid-remote role as you take on some tough challenges.

**Primary Responsibilities**:

- Assist in efforts to enhance ease of use of physician portal and future services enhancements
- Assist providers and members with basic inquiries about claims, authorizations, benefits, and other issues
- Designs and implements programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers
- May also be involved in identifying and remediating operational short-falls and researching and remediating claims

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**:

- High School Diploma/GED (or higher)
- 2+ years of account management experience working with a medical group or IPA in a managed care environment
- 2+ years of experience working in a similar position in the healthcare industry or in customer service supporting providers and their offices
- 2+ years of experience in customer service in a health care setting
- 2+ years of experience with managed care and self-insurance products and benefits
- Ability to work in office 2-3 days a week at 1901 Solar Dr. Ste 200 Oxnard, CA 93036
- Ability to travel 20-30% of the time

**Preferred Qualifications**:

- Experience working with HMO/IPA as well as health plan knowledge
- Familiarity with third party administrator operations such as eligibility, prior authorization, claims administration and provider network administration

**Soft Skills**:

- Organizational skills
- Project management
- All Telecommuters 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._

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