Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm) The Provider Relations Representative is responsible for the full range of provider relations and service interactions within UnitedHealth Group, including working on escalated provider issues related to claims issues and operational shortfalls, ease of use of physician portal and future service enhancements, and training & development of external provider education programs. Provider Relations Representatives design and implement programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Responsibilities also include directing and implementing strategies relating to the development and management of a provider network, identifying gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs, and may also be involved in identifying and remediating operational short - falls and researching and remediating claims. Primary Responsibilities:Use pertinent data and facts to identify and solve a range of problems within area of expertise Investigate non - standard requests and problems, with some assistance from others Work exclusively within a specific knowledge area Prioritize and organize own work to meet deadlines Provide explanations and information to others on topics within area of expertise
Required Qualifications:2+ years of provider relations and / or provider network experience 1+ years' experience with Medicare and Medicaid regulations 1 year of internal or external client presentation experience Intermediate level of proficiency with MS Word, Excel and PowerPoint Ability to travel throughout the statePreferred Qualifications:Bachelor's degree Strong relationship building skills Intermediate level of proficiency in claims processing and issue resolution Ability to work independently and remain on task Good organization and planning skills Ability to prioritize and meet deadlines from multi - staff members within the departmentCareers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV / AIDS and high - risk pregnancy. Our holistic, outcomes - based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm) 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. Job Keywords: UnitedHealth Care, Provider Relations, Medicaid, Community and State, Medicare, Provider Network, St. Louis, MO, Missouri
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.