Provider Engagement Representative - Remote in Idaho

Lensa; Meridian (ID); Remote; USD 59,000 - 117,000; Full time

Job summary

Lensa is seeking a Provider Engagement Representative to manage relationships with Skilled Nursing Facilities in Idaho. This role involves developing provider education programs, conducting meetings, and ensuring compliance with Medicare/Medicaid regulations. Candidates should have experience in provider relations and be able to travel within Idaho. The position offers a competitive salary range and comprehensive benefits.

Benefits

Comprehensive benefits package

Incentives

Equity stock purchase

401k contributions

Qualifications

• 2+ years of provider relations or provider network management experience.
• 1+ years of experience with Medicare/Medicaid regulations.
• Ability to travel 25% within Idaho.

Responsibilities

• Develop and maintain relationships with Skilled Nursing Facilities.
• Design programs to nurture relationships between health plan and providers.
• Support education opportunities through interactions.

Skills

Provider relations

Network management

Communication

Problem-solving

Tools

MS Word

Excel

PowerPoint

Outlook

Job description

Provider Engagement Representative - Remote in Idaho

1 day ago Be among the first 25 applicants

Lensa is the leading career site for job seekers at every stage of their career. Our client, UnitedHealth Group, is seeking professionals. Apply via Lensa today!

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

The Provider Engagement Representative (PER) will manage business relationships for contracted Skilled Nursing Facilities (SNF) for all UHC lines of business in Idaho. Responsibilities include addressing provider issues, call quality, and developing external provider education programs. The PER will conduct in-person meetings with Institutional Special Needs Plan (ISNP) facilities to support the Senior Community Care (SCC) business in meeting growth targets within the market.

The PER collaborates enterprise-wide with other business units (Care Transitions, Optum Health) and supports growth, affordability, and quality initiatives for Institutional and Institutional-Equivalent Special Needs Plans. This role involves facilitating Business Review Meetings, Joint Operating Committee, and Provider Engagement Meetings for SCC.

If you are located in Idaho, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities

1. Develop and maintain overall UnitedHealthcare business relationships with Skilled Nursing Facilities & Assisted Living Facilities
2. Design and implement programs to build and nurture positive relationships between the health plan, providers (physicians, hospitals, ancillary services), and business office managers
3. Manage strategies related to the development of a provider network
4. Support education opportunities on UnitedHealthcare businesses through in-person and telephonic interactions
5. Identify gaps in network composition and services to assist contracting and development staff
6. Lead or support external meetings with Skilled Nursing Facility staff to review performance, contracts, and reimbursement opportunities
7. Provide explanations and information on relevant topics within area of expertise
8. Identify ancillary provider gaps and support contracting of new providers
9. Prioritize and organize work to meet deadlines across functions
10. Investigate non-standard requests/issues before escalation
11. Update and maintain Compass Data Base with information from meetings
12. Support Post-Acute Priorities and growth initiatives for ISNP business
13. Educate facilities on Medication Adherence requirements
14. Provide outreach and education on policies, initiatives, and performance

You’ll be rewarded and recognized for your performance in an environment that challenges you and provides development opportunities.

Required Qualifications

• 2+ years of provider relations or provider network management experience
• 1+ years of experience with Medicare/Medicaid regulations
• Proficiency with MS Word, Excel, PowerPoint, and Outlook
• Driver’s License and reliable transportation
• Ability to travel 25% within Idaho

Preferred Qualifications

• Experience in skilled nursing or assisted living facilities
• Ability to prioritize and meet deadlines
• Familiarity with claims processing and issue resolution
• Adherence to UnitedHealth Group’s Telecommuter Policy

The salary range is $59,500 to $116,600 annually, based on full-time employment and various factors. Benefits include comprehensive packages, incentives, equity stock purchase, and 401k contributions. We are committed to equitable care and diversity.

At UnitedHealth Group, our mission is to help people live healthier lives and improve the health system for everyone. We aim to address health disparities and promote environmental sustainability.

OptumCare is an Equal Employment Opportunity employer and a drug-free workplace, requiring a drug test before employment.