Job type full-time
Full job description
Unitedhealthcare is a company that`s on the riseWe`re expanding in multiple directions, across borders and, most of all, in the way we thinkHere, innovation isn`t about another gadget, it`s about transforming the health care industryReady to make a difference? make yourself at home with us and start doing your life`s best work.(sm)
Expanding access to affordable, high quality health care starts hereThis is where some of the most innovative ideas in health care are created every dayThis is where bold people with big ideas are writing the next chapter in health careThis is the place to do your life`s best work.
The provider relations advocate role is a professional, self-directed individual who will serve as the point of contact to take in and resolve complex operations issues the assigned provider account is experiencing, proactively educate on new products and programs, bring actionable data and tools to assist their organization with achieving their business goals, as well as anticipate challenges their organization might face, while also assisting with finding solutions by working across uhc’s dynamic and matrixed organization for assigned uhc strategic and core provider accounts in conjunction with their affiliates representing uhc’s top revenue generating contracts.
The provider advocate will be the assigned single point of contact for the healthcare professional’s organization representing both government and commercial products to build and improve physician and practice manager satisfaction for uhcThis externally focused position will maximize the providers` ability to interact with uhc through both pre-scheduled engagements with the healthcare professional’s organizational representative to discuss new and upcoming changes occurring within uhc that will impact their specific account, discussing the healthcare professional’s organizational service issues, while also engaging on an ad hoc basis as the advocate either identifies or learns of a trending issue that might impact any of their assigned accounts.
The provider advocate works across the organization to better understand if any initiatives or issues might impact their assigned provider account, and while a pipeline of initiatives with tentative rollout timelines exists, the provider relations advocate will have ownership of ensuring applicability of the various initiatives as it relates to their assigned provider accounts and have the autonomy to determine how best to engage ensuring their assigned account has what they need to be successful.
If you are located in the state of mn, you will have the flexibility to telecommute* as you take on some tough challenges.
Provider relations advocates must possess an inherent ability to problem-solve complex and novel issues that may not have a clear path to resolution.
To be successful, the advocate must constantly build upon their own experience and understanding of the enterprise and have a high degree of resilience and persistence to root-cause issues and see through to resolution because standard operating procedure guidelines for most issues do not exist or are limited in scope
Working across dynamic/matrixed org
Understanding assigned provider account’s practice management system to proactively identify issues
Triage and determine root cause through researching data and claims systems for all lines of business for of escalated claims issues impacting a provider’s accounts receivable, including capitated requirements
Work across the enterprise to design and implement solutions to identified trend issues, through reporting, improvements to processing instructions, or other innovations
Where applicable, determine broader impact of identified root cause issues beyond the provider where the topic was initiated
Communicate with and educate providers on outcomes of root cause analyses, including proposed actions for the provider to improve their revenue cycle experience, including education on billing/coding errors, reimbursement policies, etc.
Establish proactive reporting and other initiatives to identify and take action on opportunities to minimize provider abrasion while solutions are being implemented
Collaborate with assigned providers on revenue-cycle based analyses of the provider’s claims data to identify trends in billing, claim processing or other practices that are negatively impacting the provider’s revenue cycle experience
Conduct live, telephonic and/or web-based meetings with providers to review findings of identified practice gaps by discuss opportunities for uhg and/or the provider to implement changes in the practice to improve the revenue cycle experience, and track progress of each agreed initiative
Conducts provider education via in-person, telephonic and/or web-based interactions, with individual providers and in group settings, such as town hall meetings, joint operating committee meetings, provider information expos or mobile service center meetingsThe educational topics will be relevant to how a provider can maximize their interaction with uhg and their revenue cycle experienceThese topics can include, but are not limited to, the following: training on uhcprovider.com, link and other self-service tools for existing and new provider staff; training on uhg policies such as reimbursement policies; industry changes such as new drgs and other codes that impact a provider’s revenue cycle; and ongoing training on new products, lines of business, systematic tools such as smart edits, etc., that are implemented within the provider relations advocate’s provider portfolio
Use appropriate tracking tools and service models to escalate service issues.
Interact with uhn and other operations areas where necessary for contract intent clarification, compliance questions, etc.
Make educational outreach as needed related to request from internal areas such as lines of business contacts, appeals and grievances, etc.
Serve as liaison between the provider and other uhg areas as needed to identify solutions for perceived revenue cycle barriers, such as clinical decisions and coding accuracy audits.
Provide feedback and guidance to network management regarding administrative compatibility, performance, and opportunities for improvement in contractual agreements
Engages with enterprise business partners to identify common billing practices and educate provider to reduce office administrative burden and increase operating efficiencies
Position requires travel to meet with providers to support all educational needs
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.
Undergraduate degree in health administration, business or equivalent combination of education and relevant experience
3+ years of experience in health plans or provider experience, with a demonstrated focus on training, education, and/or revenue cycle work
3+ years of project management expertise
Proficiency with ms office suite, sharepoint, and customer management software
Integrated knowledge of uhc data and claims platforms with an understanding of complex provider data record setup to enable identification of potential issues
Basic knowledge of cpt and icd-10 coding
Understanding of provider practice management
Ability to become a trusted advisor for assigned provider accounts through demonstration of our cultural values of integrity, compassion, relationships, innovation, and performance
Sound customer service skills with critical thinking skills and confidence to evaluate and develop solutions
Resident of minnesota
Experience in physician billing capacity, claims level audit, recovery operations experience with claims data knowledge
Experience with claims platforms or healthcare platforms
Experience working in a capitated/delegated or shared risk environment
Experience managing, coordinating and/or explaining complex capitated-delegated processes including cap-deductions and explanations
Ability to work within multiple complex technology and enterprise-wide systems
Ability to prioritize tasks and work independently and effectively under time constraints
Excellent verbal and written communication skills with the ability to communicate effectively with external providers
Solid analytical, critical reasoning and organizational skills
Sound interpersonal skills, establishing rapport and working well with internal partners
Sound self-management skills, ability to handle rapid change and an affinity for continuous learning
Careers with unitedhealthcareLet`s talk about opportunityStart with a fortune 5 organization that`s serving more than 85 million people already and building the industry`s singular reputation for bold ideas and impeccable executionNow, add your energy, your passion for excellence, your near-obsession with driving change for the betterGet the picture? unitedhealthcare is serving employers and individuals, states and communities, military families and veterans where ever they`re found across the globeWe bring them the resources of an industry leader and a commitment to improve their lives that’s second to noneThis is no small opportunityIt`s where you can do your life`s best work.(sm)
Colorado residents only: the salary range for colorado residents is $64,800 to $116,000Pay is based on several factors including but not limited to education, work experience, certifications, etcIn addition to your salary, unitedhealth group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements)No matter where or when you begin a career with unitedhealth group, you’ll find a far-reaching choice of benefits and incentives.
*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 workplaceCandidates are required to pass a drug test before beginning employment.
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