Provider Engagement Representative - Remote in Massachusetts

Lensa; Brockton (MA); Remote; USD 59,000 - 117,000; Full time

Job summary

A leading healthcare company seeks a Provider Engagement Representative to manage relationships with Skilled Nursing Facilities in Massachusetts. This remote role involves strategic networking, provider education, and ensuring compliance with Medicare/Medicaid regulations. Candidates should have experience in provider relations and the flexibility to travel within the state.

Benefits

Comprehensive benefits package

Incentives and recognition programs

Equity stock purchase

401k contribution

Qualifications

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

Responsibilities

• Manage business relationships with Skilled Nursing Facilities.
• Implement strategies for network management and provider education.
• Lead external meetings to review performance and contracting needs.

Skills

Provider relations

Network management

Communication

Organization

Education and training skills

Education

Bachelor's degree

Tools

MS Word

Excel

PowerPoint

Outlook

Job description

Provider Engagement Representative - Remote in Massachusetts

Provider Engagement Representative - Remote in Massachusetts

3 days ago Be among the first 25 applicants

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for UnitedHealth Group.

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 Massachusetts, including working on end-to-end provider issues and call quality, and training & development of external provider education programs. The PER will conduct in-person meetings with facilities supporting the Senior Community Care (SCC) business to meet growth plans within the market.

The PER collaborates enterprise wide with other business units (Care Transitions, Optum Health) and provides support for Institutional and Institutional-Equivalent Special Needs Plan growth, affordability, and quality. This role facilitates and coordinates Business Review Meetings, Joint Operating Committee, and Provider Engagement Meetings for SCC.

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

Primary Responsibilities

• Develop and maintain overall UnitedHealthcare business relationships with Skilled Nursing Facilities & Assisted Living Facilities
• Designs and implements programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.) and business office managers
• Direct and implement strategies relating to the development and management of a provider network
• Support all education opportunities on UnitedHealthcare businesses which include in person and telephonic interactions
• Identifies gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs
• Lead and/or support external facing Account and business review meetings with key Skilled Nursing Facility staff to review financial performance, contract methodology, and reimbursement opportunities
• Provide explanations and information to others on topics within area of expertise
• Identify ancillary provider gaps, and support contracting of new providers in areas where needed
• Prioritize and organize own work to meet deadlines cross functionally within the organization
• Investigate non-standard requests and issues, prior to escalation if needed
• Compass Data Base - update & maintain regularly with information following AR, Bus Review and JOC Meetings with facilities
• Support Post-Acute Priorities
• ISNP and Business Development - assist with planned growth initiatives for ISNP business
• Education and Training to facilities on Medication Adherence requirements for members
• Provide outreach and education on updated policies, new initiatives, performance, and others as necessary
  
  

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

• 2+ years of provider relations or provider network management experience
• 1+ year of experience with Medicare/Medicaid regulations
• Intermediate level of proficiency with MS Word, Excel, PowerPoint and, Outlook
• Driver’s License and access to a reliable transportation
• Ability to travel 25% of the time within Massachusetts
  
  

Preferred Qualifications

• Experience working in a Skilled Nursing or Assisted Living Facility
• Familiarity with claims processing and issue resolution
• Ability to prioritize and meet deadlines
• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
  
  

The salary range for this role is $59,500 to $116,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

If you have questions about this posting, please contact [e-mail]

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  IT Services and IT Consulting

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