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Provider Outreach Specialist

4 months ago

Pittsburgh, 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. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life’s best work. SM

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 Provider Outreach Specialist role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. Your expertise in provider networks can help us build in the next phase of evolution. In this role, you'll use your expertise and analytical skills to help determine how clinical providers group up by specialty and service line. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 5 leader.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Inbound and outbound calling to connect virtually in order to establish positive, long-term, consultative relationships with physicians and medical groups

  • Functioning independently with outreach to provider groups to discuss Optum tools and programs focused on improving the quality of care for Medicare Advantage, Medicaid and ACA Members

  • Provide support for Risk and Quality Client Programs such as Healthcare Patient Assessment Form by ensuring correct delivery of data/forms to the correct providers, portal training and the return of the data to coding ops, ensuring accurate payments are occurring for each provider based on client contract

  • Assist providers in understanding quality and CMS-HCC Risk Adjustment driven payment methodology and the importance of proper chart documentation of procedures and diagnosis coding

  • Delivers diagnosis coding tools to providers

  • Collaborates with doctors, coders, facility staff and a variety of internal and external personnel on a wide scope of Risk Adjustment and Quality education efforts

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) OR 2+ years of experience of Medicare Advantage, Medicaid, and ACA programs

  • 1+ years of Provider Support experience, high volume preferred (80 – 100 outreaches a week)

  • 6+ months experience with Medicare Advantage, Medicaid, or ACA programs

  • 6+ months experience working within a HIPAA environment

  • Intermediate level of proficiency in MS Office (Excel (Pivot tables, excel functions), PowerPoint and Word)

Preferred Qualifications:

  • 1+ years of experience with provider groups within an office environment or provider services

  • Knowledge of HEDIS and Stars

  • Ability to work independently toward individual and team metrics

  • Ability to interact and verbally communicate effectively with provider offices and all levels of personnel in a professional, courteous, and effective manner with excellent customer service skills

  • Demonstrated organizational and prioritization skills

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, Hawaii or Washington Residents Only : The hourly range for California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, or Washington residents is $23.22 to $45.43 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

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.

#RPO, #green