Strategic Provider Engagement Lead

UnitedHealth Group; Nashville (TN); Presencial; USD 73.000 - 130.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Comprehensive benefits package

Equity stock purchase program

401k contribution

Incentive and recognition programs

Descripción de la vacante

UnitedHealth Group in Nashville is seeking a Senior Provider Engagement Specialist to serve as a subject matter expert in Client Service operations. You will analyze data, develop strategies, and maintain relationships with provider groups to support revenue and quality outcomes.

The role partners with leadership to implement solutions, monitor utilization trends, and produce reports for stakeholders. Travel up to 70% may be required; strong communication and presentation skills are essential.

Formación

• 5+ years of experience in a related medical field or health plan setting.
• Experience with Medicare health care operations including HEDIS, CMS reimbursement models, and Medicare Advantage.
• Experience developing long-term positive working relationships.
• Experience communicating and facilitating strategic meetings with groups of all sizes.
• Experience working independently, using good judgment and decision-making.
• Experience conducting performance evaluations to identify performance measures or indicators and the actions needed to improve or correct performance.
• Knowledge of state and federal laws relating to Medicare.
• Proficiency in Microsoft Word, Excel and PowerPoint.
• Reliable transportation and ability and willingness to travel, up to 70%.

Responsabilidades

• Analyze risk pool and provider group performance to determine areas of focus or improvement opportunities.
• Develop strategies and action plans that align provider pools and groups with company initiatives, goals (revenue and expense) and quality outcomes.
• Drive processes and improvement initiatives that directly impact revenue, HEDIS/STAR measures and quality metrics.
• Use and analyze data to identify trends, patterns and opportunities for the business and clients.
• Collaborates with internal clinical services teams to monitor utilization trends and risk pools to assist with developing strategic plans.
• Assists provider groups with investigating standard and non-standard requests and problems, including claims and member support services.
• Maintains effective support services by working with leadership and cross-functional teams.
• Demonstrate understanding of providers' business goals to facilitate issue resolution.
• Performs all other related duties as assigned.

Conocimientos

Communication skills

Presentation skills

Problem solving

Conflict resolution

Travel willingness

Herramientas

Microsoft Word

Microsoft Excel

PowerPoint

Descripción del empleo

UnitedHealth Group in Nashville is seeking a Senior Provider Engagement Specialist to serve as a subject matter expert in Client Service operations. You will analyze data, develop strategies, and maintain relationships with provider groups to support revenue and quality outcomes.

The role partners with leadership to implement solutions, monitor utilization trends, and produce reports for stakeholders. Travel up to 70% may be required; strong communication and presentation skills are essential.