The Provider Account Manager (PAM) role leverages your solid customer service and health care claim experience to resolve challenges for our national network providers. In this professional role, a self-directed individual will serve as the point of contact to take in and resolve complex operational issues and proactively educate providers on new products and programs. As the single point of contact, you will bring actionable data and tools to assist providers with achieving their organization's business goals, as well as anticipate challenges their organization might face, and identify solutions across UHG's dynamic and matrixed organization representing UHC's top revenue generating contracts.
This role will develop and execute engagement strategies to support UHG initiatives and identify and collaborate with key stakeholders of our largest providers.
If you are located within commutable distance to Western NY state, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:- Primary responsibility for managing strategic and account aligned health systems and hospital-based providers across multiple lines of business
- Success will be supported by your ability to constantly build upon your own experience and understanding of the enterprise
- Where Standard Operating Procedures (SOP) guidelines may not exist or are limited in scope, it will require a high degree of resilience and persistence to provide root-cause analysis, see tasks through to resolution, identify trends, implement solutions and education the provider on outcomes
- Possess an inherent ability to problem-solve complex and novel issues that may not have a clear path to resolution
- Triage and determine root cause through researching data and claims systems for all Lines of Business for escalated claims issues impacting a provider's Accounts Receivable, including capitated requirements. Where applicable, determine broader impact of identified root cause beyond the provider where the topic was initiated
- Engage with enterprise business partners to identify common billing practices and education providers to reduce office administrative burden and increase operating efficiencies
- Communicate and provide education to providers on outcomes of root cause analyses, including proposed actions for the provider to improve their revenue cycle experience
- Provider education may be provided in -person, telephonic and/or web-based interactions
- Coordination and independently leading monthly Operational meetings with Strategic and account aligned providers. This includes the coordination of the meeting, creating agendas, facilitating, sending out meeting minutes and tracking open/closed items
- Proven ability to assess and interpret customer needs and requirements
- Manage provider issue tracking logs and track to completion
- Demonstrate as an expert and become a trusted advisor for assigned Provider Accounts through demonstration of our Cultural Values: Integrity, Compassion, Relationships, Innovation, and Performance
- Position requires travel to meet with providers to support on-site meetings and educational needs
- Ability to prioritize work and be flexible to change
- Solid self-management skills, and an affinity for continuous learning
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:- 5+ years of experience in health plans or provider experience, with a demonstrated focus on training, education, and/or revenue cycle work
- 2+ years of project management experience with the ability to coordinate/schedule, independently facility Monthly Operational meetings with assigned providers, including creating agendas, taking meeting minutes and sending out summaries
- 2+ years of experience working with ISET, Cirrus, CSP Facets, NDB, IMPACT/Service Now, and Spire (or any combination there-of)
- Proven ability to prioritize tasks and work independently and effectively under time constraints
- Basic knowledge of CPT and ICD-10 coding
- Proficiency with MS Office suite, SharePoint, and customer management software
- Willing and able to travel up to 10%
- Willing and able to commute within Western NY state
Preferred Qualifications:- Integrated knowledge of UHC Data and Claims Platforms with an understanding of complex provider data record setup to enable identification of potential issues
- Experience in provider billing capacity, claims level audit, recovery operations experience with claims data knowledge
- Ability to work within multiple complex technology and enterprise-wide systems
- Experience with claims platforms or healthcare platforms
- Experience working in a capitated/delegated or shared risk environment
- Experience managing, coordinating and/or explaining complex capitated-delegated processes including cap-deductions and explanations
- Solid customer service skills with critical thinking skills and confidence to evaluate and develop solutions
- Solid analytical, critical reasoning and organizational skills
- Excellent verbal and written communication skills with the ability to communicate effectively with external providers
- Solid interpersonal skills, establishing rapport and working well with internal partners
*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 salary for this role will range from $72,800 to $130,000 annually 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.
