Provider Relations Advocate - Telecommute - East Texas

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm)

The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This TX Provider Relations Advocate (Long-Term Services & Support LTSS) role with UnitedHealth Group will call on your knowledge, your energy, and your commitment to making health care work more effectively for more people. We're building better, more effective provider networks every day.

In this role, you'll use your solid customer service orientation and knowledge of insurance claims to serve as an advocate for providers in our networks. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 5 leader.

If you are located in East Texas, you'll enjoy the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

• Assist in end-to-end provider claims and help enhance call quality
• Assist in efforts to enhance ease of use of physician portal and future services enhancements
• 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

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:

• 2+ years of provider relations and/or provider network experience
• 2+ years of health care/managed care experience
• 2+ years of customer service experience
• 2+ years of experience in claims processing and issue resolution
• 1+ years of experience with Medicare or Medicaid regulations
• Proficiency with MS Office (Outlook, Word, Excel, PowerPoint)
• Travel up to 75% of time within Smith, Henderson, Nacogdoches, Harrison, Bowie, and/or MRSA Northeast TX service delivery areas
• Valid driver's license and good driving history (post COVID restrictions)
• Insured, reliable transportation that will enable travel within this designated area
• Live in within commutable distance Smith, Henderson, Nacogdoches, Harrison, Bowie, and/or MRSA Northeast TX
• Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance

Preferred Qualifications:

• Bachelor's or Master's degree
• Conflict resolution experience
• CMS proficiency

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low- income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

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.

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