Provider Relations Representative - Falls Church, VA
January 14, 2018
Falls Church, Virginia
Position Description:This is an opportunity that's all about where you've been. Your experience. Your potential. Your skills. All pretty strong up to now. It's also an opportunity about what's ahead. Because on the team at UnitedHealth Group, your potential and your impact can be career changing. We're 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 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. Great opportunity comes with significant challenge. You'll be part of a performance driven, fast paced organization that is serving multiple markets and you'll be ensuring proper implementation of complex contracts.Primary Responsibilities:Assist in end-to-end provider claims process and help enhance call qualityAnswer questions about the health plan and operational processesContribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managersProvide direction in use of physician portal and offer input for future services enhancementsSupport 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 teams
Required Qualifications:High School Diploma / GED or higher 1+ year of managed care or medical insurance experience2+ years experience in a claims, customer service or provider support roleProficiency with MS programs including Excel (create spreadsheets, sort / filter / manipulate data) Preferred Qualifications:Bachelor's Degree or higher preferredSoft Skills:Proven oral communication skills including telephone etiquetteThe 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.SMCareers 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.SMDiversity 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 Relations Representative; Falls Church, VA; managed care; medical insurance; claims; customer service; provider support; Excel
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.