Provider/Customer Relations Advocate - Texas

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) 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
 

Required Qualifications:

Highschool diploma
2+ years of provider relations and / or provider network experience
Intermediate level of proficiency in claims processing and issue resolution
1+ years experience with Medicare and Medicaid regulations
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
Preferred Qualifications:

Familiar with Medicaid
Careers 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.(sm)
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, advocate, claims, network, telecommute, Waco, Beaumont, Temple, Hidalgo, Sugarland, TX, Texas