UnitedHealth Group

Senior Provider Relations Representative

UnitedHealth Group • $72K — $130K *
San Diego, CA 92154In-Person
Healthcare
5 - 7 years of experience
1 month ago
Job Overview by Ladders

Qualifications

  • 5+ years of experience in managed care
  • Proven experience in managed care operations
  • Experience in training on managed care policies and procedures
  • Skilled in organizing meetings and documenting minutes
  • Knowledge of CPT and ICD-9 Codes
  • Ability to interpret contract language and coverage definitions
  • Strong communication, problem solving, and organizational skills
  • Proficient with Microsoft Office and managed care software

Responsibilities

  • Coordinate and manage meetings within assigned territory
  • Serve as a resource for internal referrals on provider issues
  • Manage the interface between providers, MSO, and health plans
  • Recruit and negotiate contracts with providers in assigned areas
  • Develop and distribute provider manuals and communications
  • Assist in internet portal user setup and troubleshooting
  • Complete additional assigned duties and participate in special projects

Benefits

  • Comprehensive benefits package
  • Incentive and recognition programs
  • Equity stock purchase
  • 401k contribution options
  • Career development opportunities
Full Job Description
Primary liaison between the client and MSO for the delivery of Managed Care Administrative Services. Responsible for concise and complete explanations of all phases of services from each MSO Department to the assigned IPA groups and resolving issues between them. Also responsible for identifying process improvement opportunities and supporting long-term relationship management strategies with provider groups.

Primary Responsibilities:

  • Coordinates and conducts meetings within assigned territory. Maintains official copies of minutes, agendas and credentialing signatures at the MSO's office. Sends announcements regarding scheduled meetings, makes phone calls to verify attendance (quorum), orders refreshments and sets up/breaks down the meetings. Prepares, or directs the preparation of, agendas, handouts and meeting minutes. Represents management at all meetings with clients in an appropriate and professional manner
  • Serves as a resource for internal referrals on provider issues. Supports the Client Services Department in resolving provider issues and responds to training needs identified by other MSO departments such as Claims and Medical Management. Interfaces with Health Plan staff as required. Effectively problem solves issues as identified; documents all contact with providers/office staff in the provider's file. Monitors client needs to evaluate satisfaction levels, and identifies trends and areas requiring improvement. Identifies recurring issues and collaborates with teams to refine training content and improve cross-departmental processes
  • Manages the interface between providers, the MSO and the health plans. Remains accessible to providers and their office staff. Leaves specific instructions about how to be reached within and outside the office. Utilizes email and the cell phone to maintain productivity within and outside the office. Schedules regular visits with physician offices to provide education, training and customer service. Establishes and maintains strong, productive relationships with office staff by providing superior customer service and effectively solving issues. Stays current with activities in the market by developing an open rapport with the offices. Represents management at all meetings with clients in an appropriate and professional manner. Collaborates with leadership to prioritize high- impact providers and proactively address network challenges
  • Recruits providers in designated geographic areas, negotiates provider contracts within specified guidelines and assists the Director of Network Management in all phases of network negotiations and contracting. Investigates interested providers for consideration by the regional committee. Notifies health plans and appropriate internal departments of provider contract and status changes. Functions as a messenger between plans and IPA clients, as applicable, during contracting functions
  • Develops provider manuals, provider directories, provider communications, and other related materials; and facilitates the distribution of such information
  • Provides feedback and recommends updates to materials to ensure clarity, consistency, and alignment with regulatory changes
  • Internet portal user set-up, training, documentation, communication and troubleshooting with vendors as necessary. Monitors common user issues and collaborates with IT to improve portal functionality and user experience
  • Completes other duties as requested and assigned. May participate in cross- functional initiatives or special projects to support department and organizational goals


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:

  • 5+ years of experience in managed care
  • Proven experience in managed care operations
  • Experience training individuals on managed care policies and procedures in small or large groups. Presentation skills
  • Experience organizing meetings and taking minutes. Ability to conduct on-line meetings and conference calls
  • Knowledge of CPT, ICD-9 Codes
  • Adept in interpreting contract language, rates, and coverage definitions
  • Ability to communicate in a professional manner, have problem solving skills and work independently
  • Excellent organizational and interpersonal skills
  • Ability to work effectively with a wide variety of people at all levels
  • Computer literacy, including competence with various word processing and managed care programs. Microsoft Office familiarity
  • Reliable transportation, valid California Driver's License and proof of insurance


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.

About UnitedHealth Group

UnitedHealth Group is a medical facility. They offer health technology, health finance, and pharmacy services. They are utilizing clinical data and intelligence to assist in the redesign, automation, and deployment of technology to streamline administrative operations and clinical decision-making. Payment systems for both consumers and providers are critical components of a health-care system.

UnitedHealth Group Careers

Joining UnitedHealth Group means becoming part of a diverse team dedicated to making a difference. As a leader in health services and innovation, our company offers a variety of job opportunities that allow professionals to leverage their skills, drive innovation, and improve lives. Work You’ll Do At UnitedHealth Group, you’ll contribute to a mission-focused environment where your expertise will influence the health and well-being of people worldwide. Our employment opportunities span across a wide range of disciplines, from healthcare specialists to data analysts, ensuring that your career journey is both dynamic and rewarding. Transform Healthcare with Your Expertise UnitedHealth Group stands at the forefront of health innovation. Our team collaborates to deliver solutions that lead to better patient outcomes. Working with us, you’ll find yourself at the intersection of technology, healthcare, and leadership, providing key insights that drive industry transformation. Join Our Global Team As part of our team, you’ll engage with over 300,000 professionals globally, dedicated to building a diverse and inclusive workplace. UnitedHealth Group is not just a company; it’s a community where you can grow your career through continuous learning and leadership opportunities. Our commitment to diversity training ensures that every team member can thrive. UnitedHealth Group Career Development We are committed to your professional growth. Explore career paths filled with promising job opportunities and internships that will harness your potential and expand your capabilities. Whether you’re a seasoned professional or a recent graduate, you’ll find that our career development programs support your ambition at every level. Innovative Work Environment At UnitedHealth Group, innovation is at the core of our operations. We encourage our team to bring forward-thinking ideas that challenge the status quo and lead to breakthrough improvements in patient care. Be Part of a Great Team Our culture fosters a collaborative and supportive environment where every member’s contribution is valued. Enjoy the benefits of being part of a global team that’s committed to making a difference in people’s lives. Future-Proof Your Career With UnitedHealth Group, your career is future-proof. Dive into a range of positions that offer both challenges and rewards. Our robust support system includes unmatched training, development programs, and certification support to propel your career forward. Stay Connected Join Our Team Discover the right position that matches your skills and interests. We are always hiring and look for passionate, curious, and solution-driven team players. Search UnitedHealth Group jobs today and take the first step towards a fulfilling career. Keep Up to Date Stay informed with career tips, insider perspectives, and industry-leading insights you can use today—all from the people who work here. Read Careers Blog Job Alert Emails Customize your subscription to receive job alerts, the latest news, and insider tips tailored to your preferences. Explore the exciting and rewarding opportunities that await at UnitedHealth Group.
Learn more about UnitedHealth Group
Size
350,000 employees
Market Cap
$493.1 billion
Industry
Healthcare
Net Income
$15.4 billion
Founded
1974
5 Year Trend
+9.2%
Revenue
$257.1 billion
NASDAQ
UNH
* Ladders Estimates

Similar Jobs

Ad banner background

Get Ready For Your
Next Interview

More Jobs at UnitedHealth Group

More Healthcare Jobs

Find similar Senior Provider Relations Representative jobs:

NationwideSan Diego, CA