SCA Provider Relationship Manager

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Identify/Analyze/Resolve Provider Issues
• Gather data from relevant systems (e.g., claims; data warehouse; payment integrity; EDI/Portal reporting; customer relations systems) and business partners (e.g., contracting; claims operations)
• Collaborate and/or participate in discussions with colleagues to identify potential root cause of issues
• Demonstrate understanding of providers' business goals and strategies in order to facilitate the analysis and resolution of their issues
• Analyze data to determine root cause of issue (e.g., identify trends and patterns; identify outliers and anomalies) and/or escalate problem to appropriate group for further analysis as necessary
• Involve leadership and/or escalate issues as necessary to implement provider solutions
• Coordinate with internal and/or external resources to implement provider solutions
• Ensure that provider solutions meet their needs and increase provider satisfaction (e.g., simplify processes)
• Communicate provider updates and information to applicable stakeholders (e.g., health plans; internal partners; providers; account managers; employer groups) regarding research and resolution of issues within applicable defined metrics (e.g., turnaround time)
• Ensure that provider data (e.g., demographics; fee schedule) is accurate through audits, re-credentialing, and/or outreach
• Provide on-boarding and orientation to new providers (e.g., ensure providers take on-line training; provide instruction on processes for network participation)
• Participate in company initiatives related to compliance or advocating company resources
• Apply knowledge of applicable health care industry practices, trends and issues to inform communications about how our products/services can benefit providers
• Communicate and advocate providers' needs to internal stakeholders in order to drive creation of solutions that meet our mutual business goals
• Develop resources and programs to assist and educate providers (e.g., web-based training; FAQ document)
• Work with internal groups to identify, understand, and/or improve internal tools, resources, systems, and capabilities that can maximize provider, member, or company performance
• Assess provider understanding and needs related to industry and company information, tools, systems, and changes
• Communicate industry and company information to providers through various means (e.g., newsletters; emails; outreach calls; teleconference; conferences; on-site meetings)
• Provide feedback to providers on quality and performance metrics/scorecards
• Educate providers on policies and procedures applicable to delivery of care (e.g., regulatory; benefit; claims)
• Educate providers on administrative tools (e.g., portal; electronic payments and statements; Intellijet; IVR)
• Educate providers on clinical tools, processes, and programs (e.g., utilization review; wellness assessments; quality/gaps in care; Premium Designation; View360; UM Template)

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:

• Driver's License and access to reliable transportation
• 2+ years of data entry experience
• 1+ years of experience within the healthcare or insurance industry
• Working knowledge of healthcare terminology including billing and claims
• Basic skills in Microsoft Office Suite, including Word, Excel, and PowerPoint
• Proven ability to perform detailed work with a high degree of accuracy

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $23.41 to $41.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

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