There are changes happening in health care that go beyond the basics we hear in the news. People like you and organizations like UnitedHealth Group are driving ever higher levels of sophistication in how provider networks are formed and operate. The goal is to improve quality of service while exploring new ways to manage costs. Here's where you come in. You'll use your strong customer service orientation and knowledge of insurance claims to serve as an advocate for providers in our networks. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 6 leader. Primary Responsibilities:Assist in end-to-end provider claims and help enhance call quality Coach, provide feedback and guide othersAssist in efforts to enhance ease of use of physician portal and future services enhancementsContribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managersHelp implement training and development of external providers through education programsIdentify gaps in network composition and services to assist network contracting and development teamsIn this role, you'll be part of a performance driven, fast paced organization that is serving multiple markets. You'll have frequent interactions with senior management and physicians as you communicate about ways to evolve ongoing processes and programs. Physician Advocate for New Mexico Market. Full Time, Telecommute considered if located in the state of New Mexico.
Required QualificationsBachelor's Degree or equivalent work experience3+ years of health care/managed care experience3+ years of provider relations and/or provider network experienceIntermediate level of proficiency in claims processing and issue resolutionIntermediate level of proficiency with MS Word, Excel and PowerPointExceptional presentation skills Must live within commutable distance of the location listed for this specific career opportunityPreferred Qualifications:Live within the vicinity of Southern New MexicoExperience with Medicare and Medicaid regulationsMS OneNote Experience with NDB, ISET and FacetsThe health system is moving ahead. You can too as you help us build new levels of provider network performance. Join us. Learn more about how you can start doing your life's best work.SM Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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 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. Keywords: Advocate, Provider Relations, NDB, Facets, ISET, New Mexico, Albuquerque, NM, Telecommute
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.