Job Description
Senior Provider Relations Representative - Remote within WA, MO, or NC
Join to apply for the Senior Provider Relations Representative - Remote within WA, MO, or NC role at United Healthcare
Senior Provider Relations Representative - Remote within WA, MO, or NC
2 days ago Be among the first 25 applicants
Join to apply for the Senior Provider Relations Representative - Remote within WA, MO, or NC role at United Healthcare
At United Healthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
This is an opportunity that's all about where you've been. Your experience. Your potential. Your skills. All solid up to now. It's also an opportunity to learn what's ahead. Because on the team at United Health Group, your potential and your impact can be career changing. We're driving ever higher levels of sophistication in how provider networks are formed and operated.
The goal is to improve the quality of service while exploring new ways to manage costs. Here's where you come in. You'll use your solid customer service and consultative skills to meet with network providers and help enhance their experience and performance. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 5 leader.
- If you are located in WA, MO, or NC, you will have the flexibility to work remotely
- as you take on some tough challenges.
- Primary Responsibilities
- Facilitate end-to-end provider issues and resolution
- Use pertinent data and facts to identify and solve a range of problems
- Investigate non-standard requests and problems
- Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers
- Help implement training and development of external providers through education programs
- Identify gaps in network composition and services to assist network contracting and development teams
- Responsible for all related aspects of issue resolution
- Claims systems utilization, claims-related business, and systems analysis
- Ensure data integrity, data security and process optimization You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
- Required Qualifications
- 3+ years of experience in a technical or metrics-based environment; preferably claims and/or customer service
- 2+ years of issue resolution experience
- 2+ years of experience in analyzing and solving customer problems in an office setting environment
- 1+ years of advanced level experience utilizing one or more of the following platforms COSMOS, CSP Facets, UNET, Cirrus, or NICE
- 1+ years of experience in communicating analysis, including trends and opportunities to clients and the business in writing and verbally
- Intermediate level of proficiency with PC based software programs and automated database management systems (Excel, PowerPoint)
- Will need to reside in WA, MO, or NC
- Willing and able to travel up to 25% within state hired
- Preferred Qualifications
- 1+ years of adjustment experience utilizing one or more of the following platforms COSMOS, CSP Facets, UNET, Cirrus, or NICE
- 1+ years of Investigation and Solutions Group resolution specialist experience
- 1+ years of escalated call experience
- 1+ years of experience solving complex problems and root cause remediation
- 1+ years of credentialing/contracting experience
- Working knowledge of multiple platforms (COSMOS, CSP Facets, UNET, Cirrus, or NICE)
- Proven ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product
- All employees working remotely will be required to adhere to United Health Group’s Telecommuter Policy. Pay is based on several factors including but not limited to local…
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