Provider Relations Advocate - Binghamton, NY Telecommute

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.(sm)



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.

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

This role will focus on tiered providers and the
success of their quality measures while coordinating with multiple departments.



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.

Primary Responsibilities:

• Analyzes and
  investigates.
• Provides
  explanations and interpretations within area of expertise.
• 
  
  Field-based;
  Frequent on-site visits and meetings with physician groups or hospital systems.
  
• 
  
  Smaller
  practices, lower spend & less complexity

Required Qualifications:

• High School Diploma/GED.
  
• 2+ years of Provider Relations and/or Provider Network experience.
• 2 + years in Claims handling and issue resolution.
• 1+ years experience with Medicare and/or Medicaid regulations.
• Ability to create, copy, edit, save & send using Word, Excel & Outlook.
• Must have personal transportation,
  State Driver's License and applicable insurance.
• 1 + year experience
  working with Hospitals/Physician's offices.

Preferred Qualifications:

• Microsoft PowerPoint.
  
• Experience CMS / STARS.

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.