Provider Relations Representative - Columbia, MD or Indianapolis, IN - Full-time / Part-time

Position Description: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.The
Provider Relations Representative is responsible for assisting in 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 Representatives assist in the
design and implementation programs to build and nurture positive
relationships between the health plan, providers (physician, hospital,
ancillary, etc.), and practice managers.The Provider Relations
Triage Representative will be responsible for resolving escalated
customer issues within an established turnaround time from the point of
receipt. The final resolutions are subject to audits to ensure quality
and accuracy in resolution. Responsibilities also include identifying
training opportunities and gaps in processes that will help increase
first call resolution and provide accurate information about products
and services. Work as part of a team and collaborate with colleagues to
expedite a resolution for complex issues and support other projects as
needed based on departmental priorities.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.
Employees in jobs labeled with SCA must support a government Service
Contract Act (SCA) agreement.Primary Responsibilities:
Supporting those who direct and implement strategiesRelating to the development and management of a provider network,Identify gaps in network composition and services to assist the network contractingDevelopment staff in prioritizing contracting needsInvolved in identifying and remediating operational short-fallsResearching and remediating claimsApply basic knowledge of theories, practices and proceduresPerform routine or structured workRespond to routine or standard requestsUse existing procedures and facts to solve routine problems or conduct routine analysesDepend on others for instruction, guidance or direction

Required Qualifications:
High School Diploma or GED1+ year of experience in a Customer Service or provider support role1+ year of managed care or medical insurance experienceExperience with Microsoft Office, Word, and ExcelPreferred Requirements:
Experience with ISET ticketing system or similarKnowledge of administering Vision insuranceRetail Optical/ Vision industry experience Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.SM
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.