Senior Provider Relations Representative - Korean Speaking

Optum; New York (NY); On-site; USD 60,000 - 90,000; Full time

Job summary

An established industry player is seeking a Senior Provider Relations Representative to enhance the health care experience. This role involves building positive relationships with providers, resolving issues, and implementing effective training programs. You will have a significant impact on network development and quality metrics, ensuring a responsive and equitable health care system. If you are passionate about making a difference in health care and possess strong relationship-building skills, this opportunity is perfect for you.

Qualifications

• 4+ years of health care/managed care experience.
• 2+ years of provider relations/network experience.
• Proficient in English/Korean.

Responsibilities

• Assist with provider claims and enhance call quality.
• Identify and solve problems using data.
• Implement training programs for external providers.

Skills

Relationship building

Flexibility

Reliability

Issue resolution

Contract maintenance

Process improvements

Operational reporting

Team collaboration

Provider network development

Provider complaint resolution

Quality metrics collection

Relationship management

Tools

MS Word

Excel

PowerPoint

Access

Job description

Job Summary:

Join UnitedHealthcare to simplify the health care experience, create healthier communities, and remove barriers to quality care. Your work will impact millions, helping to build a more responsive, affordable, and equitable health care system.

Responsibilities:

• Assist with provider claims and enhance call quality.


• Identify and solve problems using data.


• Investigate non-standard requests.


• Design and implement programs to build positive relationships with providers.


• Implement training and development programs for external providers.


• Identify gaps in network composition and assist with network development.

Key Skills:

• Relationship building, flexibility, and reliability.


• Hands-on experience with issue resolution and contract maintenance.


• Engage providers in process improvements.


• Produce and distribute operational reports.


• Collaborate with other managers to foster teamwork.


• Implement strategies for provider network development.


• Resolve provider complaints to improve ratings and referrals.


• Collect charts for HEDIS/STAR measures and quality metrics.


• Manage relationships with key Asian medical groups.

Qualifications:

• 4+ years of health care/managed care experience.


• 2+ years of provider relations/network experience.


• Proficient in English/Korean.


• Proficiency with MS Word, Excel, PowerPoint, and Access.


• Intermediate proficiency in claims processing and issue resolution.


• Familiarity with Medicare and Medicaid regulations.

Full description: https://careers.unitedhealthgroup.com/job/21113285/senior-provider-relations-representative-korean-speaking-flushing-ny/