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. If you are located in the state of Pennsylvania you will have the flexibility to telecommute* as you take on some tough challenges; Must be based in Delaware or Central Pennsylvania
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 claim and call quality, ease of use of physician portal and future service enhancements, and training & development of external provider education programs. Designs and implements programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Directs and implements strategies relating to the development and management of a provider network. Identifies gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs. May also be involved in identifying and remediating operational short-falls and researching and remediating claims. Primary Responsibilities:
Assist in end-to-end provider claims and help enhance call quality
Identify gaps in network composition and services to assist network contracting and development teams
Coach, provide feedback and guide others
Assist in efforts to enhance ease of use of physician portal and future services enhancements
Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers
Help implement training and development of external providers through education programs
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.
3+ years of health care/managed care experience
3+ years of provider relations and/or provider network experience strongly preferred
1 or 2+ years of claims processing and issue resolution
1+ years of experience with Medicare and Medicaid regulations
Proficiency with MS Word, Excel, PowerPoint and Access
Ability for some local travel in territory of Central PA
The 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)
*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.
Job Keywords: Sr Network Account Manager, Telecommute, PA, Pennsylvania, DE, Delaware