The
Dental Provider Relations Advocate is responsible for the full range of provider relations and service interactions within UnitedHealth Group, including being the face of UnitedHealthcare (UHC) Dental, in addition to Healthplex and its clients, in the field with our providers and the liaison for provider contracting questions, claim and call quality, ease of use of provider web portal, future service enhancements and training & development of provider education programs. The role may be involved in identifying and remediating operation short-falls and researching and resolving complex claims and claims issues. The role also ensures the network composition includes an appropriate distribution of provider specialties, including recruitment and contracting as needed. This role may involve Commercial, Medicare and Medicaid programs.
This position will cover an assigned territory in NY but may not be limited to NY. The individual selected should live within/or proximal to Upstate NY to allow for provider visitation.
Primary Responsibilities:- FQHC relationship owner
- Provider relationship manager
- Targeted Provider recruitment
- Provider education
- Provider at risk escalation resource
- Member escalation contact
- Network adequacy manager
- Special project manager
- Market expert
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:- 1+ years of experience in a network management related role, such as contracting, provider relations or provider services and/or experience working in a dental office in a management capacity
- 1+ years of experience with Medicaid and Medicare reimbursement methodology (ie. APG, PPS, FFS, Capitation)
- Basic level of proficiency with MS Excel
- Travel 20-25% which may include provider visits, conferences, meetings, etc. in upstate New York
- Access to reliable transport and valid US driver's license
Preferred Qualifications:- Knowledge of PPO reimbursement methodologies
- Provider contracting experience
- Knowledge of Dental products/providers
- Knowledge of claim processing systems and guidelines
- Excellent verbal and written communication skills
- Strong interpersonal skills, ability to establish rapport and work well with others
- Undergraduate degree or equivalent experience
- Strong customer service skills
*All Telecommuters 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 salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
