Provider Relations Advocate

Optum; McAllen (TX); In loco; USD 60.000 - 107.000; Tempo pieno

Vantaggi offerti da questo lavoro

Paid Time Off

Medical Plan options with HSA

Dental, Vision, Life & AD&D Insurance

401(k) Savings Plan

Education Reimbursement

Employee Discounts

Employee Assistance Program

Employee Referral Bonus Program

Voluntary Benefits

Descrizione del lavoro

WellMed, part of the Optum family, is seeking a Provider Relations professional in McAllen, TX. This role supports end-to-end provider claims, enhances physician portal usability, and fosters strong relationships among health plans, providers, and practice managers.

Qualifications include 4+ years in health care/managed care, 2+ years in provider relations, 1+ year in claims processing, and knowledge of Medicare/Medicaid regulations. Travel of 50-75% within the market is required.

Competenze

• 4+ years of health care/managed care experience.
• 2+ years of provider relations and/or provider network experience.
• 1+ years of experience in claims processing and issue resolution.
• 1+ years of experience with Medicare and Medicaid regulations.
• Intermediate level of proficiency with MS Office.

Mansioni

• Assist in end-to-end provider claims and help enhance call quality.
• Assist in efforts to enhance ease of use of physician portal and future services enhancements.
• Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers.
• Support development and management of provider networks.
• Help implement training and development of external providers through education programs.
• Identify gaps in network composition and services to assist network contracting and development teams.
• Ability to travel as needed 50 - 75% within market

Conoscenze

Health care experience

Provider relations experience

Claims processing experience

Medicare/Medicaid regulations

MS Office proficiency

Formazione

Bachelor's degree in a related field

Strumenti

MS Office Suite

Descrizione del lavoro

Explore opportunities with WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will be part of a team who shares your passion for helping people achieve improved health outcomes. Explore rewarding opportunities for physicians, clinical staff and non-patient-facing roles. Join us and discover the meaning behind Caring. Connecting. Growing together.

Location

3300 N McColl Rd, McAllen, TX 78501

Hours

Monday-Friday 8am-5pm

Primary Responsibilities

• Assist in end-to-end provider claims and help enhance call quality
• Assist in efforts to enhance ease of use of physician portal and future services enhancements
• Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers
• Support development and management of provider networks
• Help implement training and development of external providers through education programs
• Identify gaps in network composition and services to assist network contracting and development teams
• Ability to travel as needed 50 - 75% within market

What Are The Reasons To Consider Working For UnitedHealth Group? Put It All Together - Competitive Base Pay, a Full And Comprehensive Benefit Program, Performance Rewards, And a Management Team Who Demonstrates Their Commitment To Your Success. Some Of Our Offerings Include

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

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

• High School Diploma/GED
• 4+ years of health care/managed care experience
• 2+ years of provider relations and/or provider network experience
• 1+ years of experience in claims processing and issue resolution
• 1+ years of experience with Medicare and Medicaid regulations Ability to travel as needed 50 - 75%
• Intermediate level of proficiency with MS Office

Preferred Qualifications

• Access to reliable transportation and valid US driver's license
• Bachelor's degree in related field

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 $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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

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