As a Senior Provider Relations Advocate at Optum, you will act as a direct interface between Optum and the affiliated physicians in Optum's Independent Physician Association (IPA) network and support their operations and performance success. This position provides continuous education, support, training and troubleshooting to physicians and their staff.
The office hub for this position is located in Murrieta, CA. This position will require regular travel across South Riverside County including but not limited to Murrieta, Hemet, Temecula, Lake Elsinore, Wildomar, Menifee.
Primary Responsibilities: - Serve as single-point-of-contact to the physician network and is an accountable owner, responsive to physician needs. Knowledgeable about incentive programs, contract reimbursement, Optum's internal processes and priorities, and other Optum initiatives, as applicable
- Monitors performance of assigned PCPs, identifies low performing PCPs and works with IPA leadership to develop action plan for specific metrics needing improvement. Works with office to effectuate action plans and monitors progress
- Intervenes and escalate issues as appropriate
- Maintains awareness of providers interested in further engaging with Optum on new business opportunities (contracts and business combinations), and on shifting market/competitive dynamics that would impact the IPA
- Works collaboratively with offices and Optum growth team to drive membership growth and retention
- Responds timely (within one business day) to provider issues, works with other groups/central departments to resolve issues and updates providers and office staff regularly through to resolution
- Build collaborative relationships with IPA physicians and their office staff
- Attend in person department and training meetings at corporate locations as directed
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 health care/managed care experience
- 3+ years of provider relations and/or provider network experience
- Experience with Medicare and Medi-Cal regulations
- Proven understanding of healthcare systems billing
- Intermediate level of proficiency in claims processing and issue resolution
- Intermediate level of proficiency with Microsoft Office applications
- Proven excellent verbal, written and interpersonal skills required, including experience drafting correspondence and preparing meeting documentation
- Ability and willing to work an office-based schedule (in the office 1-2 days per week when not in the field)
- Ability and willing to travel 50-75% within assigned territory
- Driver's License and access to reliable transportation
Preferred Qualifications: - Provider recruitment and contracting experience
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 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
