Nursing Home Provider Relations Advocate - Dallas, TX - Plano, Fort Worth, Richardson Areas

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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.

Primary Responsibilities:

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


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


• Work exclusively within a specific knowledge area


• Prioritize and organize own work to meet deadlines


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

This position will focus on working with Skilled Nursing Facilities (nursing homes) in Texas. You will be educating key Nursing Home staff about UHC Nursing Home, Medicare Advantage and Commercial product lines and how to effectively work with the MCO for the Medicare Advantage system. You will be assigned a number of facilities to oversee on an ongoing basis. 

Required Qualifications:

• Undergraduate degree or equivalent experience


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


• 1+ years of experience with Medicare and Medicaid regulations


• Intermediate level of proficiency in claims processing and issue resolution


• Exceptional presentation, written and verbal communication skills


• Ability to work independently and remain on task


• Good organization and planning skills


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


• Intermediate level of proficiency with MS Word, Excel, PowerPoint and Access

UnitedHealth Group is working to create the health care system of tomorrow. Already Fortune 14, 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, 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: Provider Relations, Dallas, Plano, Fort Worth, Richardson, Texas, TX