Sr. Provider Relations Advocate - Telecommute in CO, WY, UT, ID
San Diego, CA, United States
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The Senior Provider Relations Advocate will be the assigned single point of contact for provider/healthcare system accounts while representing both government and commercial products to build and improve physician and practice manager satisfaction with UHC. This externally focused position will maximize the providers' ability to interact with UHC through both pre-scheduled engagements with the healthcare professional’s organizational representative to discuss new and upcoming changes occurring within UHC that will impact their specific account, discussing the provider/healthcare system’s organizational service issues, while also engaging on an adhoc basis as the Advocate either identifies or learns of a trending issue that might impact any of their assigned provider/healthcare system accounts.
The Senior Provider Relations Advocate will have ownership of ensuring applicability of the various initiatives as it relates to their assigned provider/healthcare system accounts and have the autonomy to determine how best to engage ensuring their assigned provider/healthcare system account has what they need to be successful.
If you are located in CO, WY, UT, ID, you will have the flexibility to telecommute* as you take on some tough challenges.
Ability to become a trusted advisor for assigned provider/healthcare system accounts through demonstration of our cultural values of Integrity, Compassion, Relationships, Innovation, and Performance
Senior Provider Relations Advocates must possess an inherent ability to problem-solve complex and novel issues that may not have a clear path to resolution. To be successful, the Advocate must constantly build upon their own experience and understanding of the enterprise and have a high degree of resilience and persistence to root-cause issues and see through to resolution because standard operating procedure guidelines for most issues do not exist or are limited in scope
Working across dynamic/matrixed organization
Understanding assigned provider/healthcare system accounts practice management system to proactively identify issues
Triage and determine root cause through researching data and claims systems for commercial and government claims for escalated claims issues impacting a provider’s accounts receivable, including capitated requirements
Work across the enterprise to design and implement solutions to identified trend issues, through reporting, improvements to processing instructions, or other innovations
Where applicable, determine broader impact of identified root cause issues beyond the provider where the topic was initiated
Communicate with and educate assigned provider/healthcare system account contacts on outcomes of root cause analyses, including proposed actions for the provider to improve their revenue cycle experience, including education on billing/coding errors, reimbursement policies, etc.
Establish proactive reporting and other initiatives to identify and act on opportunities to minimize provider abrasion while solutions are being implemented
Collaborate with assigned provider/healthcare system account contacts on revenue-cycle based analyses of claims data to identify trends in billing, claim processing or other practices that are negatively impacting the provider’s revenue cycle experience
Conduct live, telephonic and/or web-based meetings with provider/healthcare system account contacts to review findings of identified practice gaps by discuss opportunities for UHG and/or the provider to implement changes in the practice to improve the revenue cycle experience, and track progress of each agreed initiative
Conducts provider education via in-person, telephonic and/or web-based interactions, with individual providers and in group settings, such as Town Hall meetings, Joint Operating Committee meetings, Provider Information Expos or Mobile Service Center meetings. The educational topics will be relevant to how a provider can maximize their interaction with UHG and their revenue cycle experience. These topics can include, but are not limited to, the following: Training on UHCProvider.com, and other self-service tools for existing and new provider staff; training on UHG policies such as reimbursement policies; industry changes such as new DRGs and other codes that impact a provider’s revenue cycle; and ongoing training on new products, lines of business, systematic tools such as Smart edits, etc., that are implemented within the Provider Relations Advocate’s provider portfolio
Use appropriate tracking tools and service models to escalate service issues
Interact with local and national network management teams and other operations areas, where necessary, for contract intent clarification, compliance questions, etc.
Make educational outreach as needed related to request from internal partners
Serve as liaison between the provider and other UHG areas as needed to identify solutions for perceived revenue cycle barriers, such as clinical decisions and coding accuracy audits
Provide feedback and guidance to network management regarding administrative compatibility, performance, and opportunities for improvement in contractual agreements
Position requires travel to meet with providers to support all educational needs
Solid self-management skills, ability to handle rapid change and an affinity for continuous learning
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.
Undergraduate degree in Health Administration, Business or related field equivalent combination of education and relevant experience
3+ years of experience in health plans or provider experience, with a demonstrated focus on training, education, and/or revenue cycle work
3+ years of project management expertise
Proficiency with MS Office suite, SharePoint, and customer management software
Basic knowledge of CPT and ICD-10 coding and workflow of healthcare claims
Understanding of provider practice management
Lives in Colorado, Wyoming, Utah, Idaho, or surrounding area
Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
Experience in physician/facility billing capacity, claims level audit, recovery operations experience with claims data knowledge
Experience with claims platforms or healthcare platforms
Experience managing, coordinating and/or explaining complex capitated-delegated processes including cap-deductions and explanations
Ability to work within multiple complex technology and enterprise-wide systems
Excellent verbal and written communication skills with the ability to communicate effectively with internal and external C-suite executives and provider contacts
Solid customer service and relationship building skills with critical thinking skills and confidence to evaluate and develop solutions
Ability to prioritize tasks and work independently and effectively under time constraints
Solid interpersonal skills, establishing rapport and working well with internal partners
Solid analytical, critical reasoning and organizational skills
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)
Colorado Residents Only: The hourly range for Colorado residents is $31.78 to $56.88. 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.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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.