Healthcare Provider Relations Advocate - New Jersey - Full-time / Part-time

Healthcare Provider Relations Advocate - Trenton, New Jersey

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)

Primary Responsibilities:

The Provider Relations Advocate is responsible for the full range of provider relations and service interactions within UnitedHealth Group, 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. Provider Relations Advocates design and implement programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers.

Responsibilities also include directing and implementing strategies relating to the development and management of a provider network, identifying gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs, and may also be involved in identifying and remediating operational short-falls and researching and remediating claims.

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  Use pertinent data and facts to identify and solve a range of problems within area of expertise



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  Investigate non-standard requests and problems, with some assistance from others



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  Work exclusively within a specific knowledge area



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  Prioritize and organize own work to meet deadlines



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  Provide explanations and information to others on topics within area of expertise

Required Qualifications:

• Experience in healthcare or managed care


• Proficiency in Microsoft Excel (formulas)


• 2+ years of provider relations and/or provider network experience


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  Proficiency in claims processing and issue resolution



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  1+ years experience with Medicare and Medicaid regulations



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  Experience working with healthcare regulatory agencies



• Working knowledge root cause analysis


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  Experience conducting research



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  Experience handling escalated customer service issues



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  Experience processing grievances



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  Experience resolving complex issues

Preferred Qualifications:

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  Undergraduate degree 


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  Ability to review data in order to make sound judgements


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  Exceptional presentation, written and verbal communication skills



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  Ability to work independently and remain on task



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  Good organization and planning skills



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  Ability to prioritize and meet deadlines from multi-staff members within the department



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  Proficiency with MS Word, PowerPoint and/or Access  

UnitedHealth Group is working to create the health care system of tomorrow.

Already Fortune 25, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.

Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

Job Keywords: Healthcare, Managed Care, Hospital Contracting, Physician Contracting, Ancillary Contracting, Provider Network, Network Development, Provider Services. Provider Education, Provider Relations