Associate Provider Services Representative

2 weeks ago

Signal Hill, 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.   

Responsible for supporting the operations of the affiliate provider network and serving as a resource for the provider network, Operations team, and provider relations teammates to drive superior clinical quality and outcomes for Optum patients.

This position is full time. Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm PST. It may be necessary, given the business need, to work occasional overtime. Our office is located at  1100 E WILLOW ST SIGNAL HILL, CA 42610 .  

We offer weeks of on-the-job training. The hours of the training will be based on schedule or will be discussed on your first day of employment.  

Primary Responsibilities:

  • Serves as administrative support for the Provider Relations team.
  • Assists in resolving provider issues by interfacing with cross functional Optum teams.
  • Processes electronic communications via email, fax and text.
  • Coordinates mass mailing and outreach projects to providers and patients.
  • Helps the Operations team plan, prepare, and execute provider events and meetings.
  • Coordinates with internal departments on status of clinician adds, terms and panel changes.
  • Serves as a point of contact for internal departments for issues related to the network.
  • Communicates relevant information from internal departments to the provider network.
  • Makes outreach and follow-up phone calls to physician offices related to specific initiatives.
  • Submits provider adds/changes, practice location adds/changes, and referral status changes ensuring data integrity in internal systems (IDX, Curo, etc.) and health plan websites.
  • Prepares health plan ID flyers for primary care physicians.
  • Responds to and resolves questions or concerns from clinicians or staff in a timely and service-oriented manner.
  • Tracks Community Meeting attendance and prepares quarterly stipend payments.
  • Manages provider network rosters.
  • Resolves and responds to patient issues in a timely manner by interfacing with Optum internal departments and/or provider offices.
  • Conducts daily review of all customer complaint files and database logs and performs any necessary follow-up with internal teams and external agencies.
  • Reports weekly, monthly, quarterly and as requested
  • Other duties as assigned.

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
  • Must be 18 years of age or older 
  • Proficiency with Microsoft Word
  • Microsoft Excel
  • Microsoft PowerPoint.
  • Excellent verbal and written communication skills.
  • Strong customer service and interpersonal skills.
  • Ability to interface with all levels of management.
  • Experience in the healthcare industry.
  • Ability to work full time. Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm PST. It may be necessary, given the business need, to work occasional overtime. 

Preferred Qualifications:

  • Prior experience in a clinic, medical group, or IPA setting working with physician networks.
  • An understanding or familiarity with managed care or population health management principles and reimbursement mechanics.
  • Knowledge of CPT II and ICD-10 coding systems.

California Residents Only:  The hourly range for this is $16.00 - $28.27 per hour.  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.

#RPO #RED

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