Provider Relations Coordinator

UnitedHealth Group; Irvine (CA); On-site; USD 28,000 - 50,000; Full time

Job summary

UnitedHealth Group seeks a Provider Relations Coordinator in Irvine, CA to act as a liaison between Optum and the physician network, delivering responsive support and coordinating administrative tasks to promote provider satisfaction and operational efficiency.

You will support onboarding, provider data maintenance, and the creation of performance reports, scorecards, and materials for improvement initiatives, collaborating across departments on data management and provider education.

Qualifications

• High School Diploma.
• 1+ years of health plan, managed care organization, medical group physician office, IPA, or related work experience.
• 6+ months Experience working within a team-oriented environment.
• Intermediate level of experience with Microsoft Suite.

Responsibilities

• Serves as a liaison between Optum and the provider network and is responsive to provider needs; responds to provider issues and coordinates resolution with other groups.
• Assists the Provider Relations team by researching and resolving issues communicated to Optum by network providers.
• Conducts outreach to the provider network to remediate inquiries and concerns from members submitted through Optum's Patient Service Center.
• Supports Provider Relations escalation process, monitors turnaround times, and participates in outreach and issue resolution.
• Assists with onboarding and ongoing data collection for providers in the Network Services and onboarding/update processes.
• Distributes targeted network communications via email, fax and mail and provides administrative support to PRMs and the PR Department.

Skills

Teamwork

Communication skills

Education

High School Diploma

Tools

Microsoft Office

Job description

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 Relations Coordinator serves as a liaison between Optum and its provider network, delivering responsive support, issue resolution, and administrative coordination to promote exceptional provider satisfaction and operational efficiency. This role supports the Provider Relations Team by facilitating provider communications, collaborating on provider data and onboarding processes, maintaining network records, and assisting with provider education and engagement activities. The Coordinator plays an integral role in quality improvement initiatives by preparing performance reports, scorecards, meeting materials, and action plan documentation; conducting provider and member outreach; and supporting efforts related to HEDIS, CMS, CAHPS, and other performance measures. Additionally, the position collaborates across departments to address provider concerns, support escalation management, monitor network trends, and contribute to provider growth, retention, and overall network performance.

Location

9 Technology Dr, Irvine, CA 92618.

Hours

Monday-Friday 8am-5pm

Primary Responsibilities

• Service Excellence:
• Serves as a point-of-contact to the physician network and is responsive to physician needs
• 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
• Assists the Provider Relations team by researching and resolving issues communicated to Optum by network providers
• Conducts outreach to provider network as needed via e-mail or telephonically to help remediate inquiries and concerns from members submitted through Optum's Patient Service Center
• Supports Provider Relations Escalation process, through appropriate triage of issues to PR Team members, monitoring turnaround times to ensure timely response, and participating in provider outreach and issue resolution
• Assists with the review, ongoing tracking and data collection for Optum's providers through the Network Services' onboarding and update processes
• Distributes targeted network communications through email, fax and mail as directed
• Provides administrative support to PRMs and PR Department and participates in special projects as assigned
• Provider Training and Data Management:
• Assists the Provider Relations team in setting up and maintaining provider e-files
• Assists the Provider Relations team in maintaining accurate and timely provider information in Optum databases including, but not limited to, maintaining PRM database
• Ensures that provider offices have a Curo, Optum Pro, and DataCORE 'account' assigned (as applicable) and assists in the resolution of provider questions/issues related to usage of these systems and other practice tools
• Quality Performance:
• Supports quality performance measures (e.g., HEDIS, CMS, CAHPS) by engaging targeted provider practices and members, collaborating on improvement workplans
• Develops and prepares monthly performance scorecards, reports, meeting materials, and action plan documentation to support PRMs' practice performance review discussions, JOMs, performance improvement initiatives and as needed/requested
• Collaborates and aligns strategies with other regional support teams (e.g., Network Services, Population Health, Government Programs)
• Conducts member or provider outreach in support of performance improvement initiatives including data collection, quality gap closures, appointment scheduling, quality education
• Growth and Retention:
• Monitors and identifies trends on membership decline and escalates to leadership as appropriate

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.)

Required Qualifications

• High School Diploma
• 1+ years of Health plan, managed care organization, medical group physician office, IPA, or related work experience
• 6+ months Experience working within a team-oriented environment
• Intermediate level of experience with Microsoft Suite

Preferred Qualifications

• 2+ years of experience in a health plan, managed care organization, medical group physician office or IPA setting
• Proven excellent communication skills
• Roles in Provider Relations or experience working with physicians/physician offices
• Experience working collaboratively with diverse, cross-functional teams to achieve shared objectives

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 hourly pay for this role will range from $20.00 to $36.00 per hour 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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