Senior Provider Relations Representative - Iselin, NJ

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 Senior 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. Senior 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. Other responsibilities include supporting those who direct and implement strategies relating to the development and management of a provider network, identify 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
Investigate non-standard requests and problems, with some assistance from others
Prioritize and organize own work to meet deadlines
Provide explanations and information to others on topics within area of expertise
Build and maintain strong business relationships
Communicate effectively with physicians and their office staff as well as with internal partners

Required Qualifications:

Undergraduate degree or equivalent experience
2+ years of managed care or medical insurance experience
1+ years experience in a claims, customer service or provider support role
Good organization and planning skills
Strong interpersonal and oral communication skills including telephone etiquette
Ability to prioritize and meet deadlines from multi-staff members within the department
Strong research and analytical skills
Basic level of proficiency with MS Excel and Word
Preferred Qualifications:


Knowledge of Medicare STARS program and HEDIS
 
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 14 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do 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.

Job Keywords: Provider Relations, Iselin, NJ, New Jersey