Provider Network Relations Specialist - Cypress, CA
January 5, 2018
Position Description: Energize your career with one of Healthcare's fastest growing companies. You dream of a great career with a great company - where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up. This opportunity is with one of our most exciting business areas: Optum - a growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader. Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation and Performance. It's that time, isn't it? You're ready for the next step forward and an opportunity to build on your skills. And it just so happens that there's never been a better time to become a part of the team at UnitedHealth Group. We're driving even 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 knowledge of insurance claims and customer service to help create strong relationships with the providers in our networks. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 6 leader.Taking a giant leap step forward comes with great challenge. You'll ensure provider service quality by making outbound calls to obtain data and verify information with providers as well as perform analysis and develop reports that help clarify operational issues and opportunities.Positions in this function are accountable for the full range of provider relations and service interactions within UHG, including working on end-to-end provider inquiries and call quality, ease of use of physician portal and future service enhancements, and training and development of external provider education programs. May also be involved in identifying and remediating operational short-falls and researching and remediating claims. Employees in jobs labeled with SCA must support a government Service Contract Act (SCA) agreement. Primary Responsibilities:Assist in the design and implementation of programs that build / nurture positive relationships between the health plan, providers and practice managersSupport development and management of provider networksHelp implement training and development of external providers through education programsIdentify gaps in network composition and services to assist network contracting and development teamsAcknowledge and resolve formal provider complaints
Required Qualifications:High School Diploma / GED1+ years of experience in a customer service or provider support roleAbility to edit and save documents with Microsoft WordAbility to sort and filter data with Microsoft ExcelAbility work Monday - Friday from 8:00 AM to 4:30 PMPreferred Qualifications:Managed care or medical insurance experienceSoft Skills: Experience in a position requiring excellent oral and written communication skills including telephone etiquetteCareers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So, when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work. 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: UnitedHealth Group, Provider Network Relations Specialist, Cypress, Customer Service, Provider Support
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.