• Job Description

  Req#: 2168406

  At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life's best work.(sm)

  There are changes happening in health care that go beyond the basics we hear in the news. People like you and organizations like UnitedHealth Group are driving ever higher levels of sophistication in how provider networks are formed and operate. The goal is to improve quality of service while exploring new ways to manage costs. Here’s where you come in. You’ll use your strong customer service orientation and knowledge of insurance claims to serve as an advocate for providers in our networks. As you do, you’ll discover the impact you want and the resources, backing and opportunities that you’d expect from a Fortune 5 leader.

  If you are located within Massachusetts, Rhode Island, or New Hampshire, you will have the flexibility to work remotely* as you take on some tough challenges

  Primary Responsibilities:

  • Assist in end-to-end provider claims and help enhance call quality
  • Provider contract review and system auditing for correct contract configuration
  • Coach, provide feedback and guide others
  • 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
  • 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
  • Work well cross-functionally with Clinical, Sales and other health plan and national departments in problem resolution and provider/customer satisfaction and growth

  In this role, you’ll be part of a performance driven, fast paced organization that is serving multiple markets. You’ll have frequent interactions with senior management and physicians as you communicate about ways to evolve ongoing processes and programs.

  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:

  • High school diploma or equivalent experience
  • 3+ years of health care or managed care experience
  • 3+ years of provider relations and/or provider network experience
  • Intermediate level of proficiency in claims processing and issue resolution
  • Intermediate level proficiency in MS Word, Excel, PowerPoint
  • Proven organization, planning, prioritizing and multi-tasking skills
  • Demonstrated ability to work independently, in a team, and cross-functionally
  • Demonstrated ability to travel up to 10% within Massachusetts

  Preferred Qualifications:

  • Undergraduate degree
  • 1+ years of experience with Medicare and Medicaid regulations
  • Proven exceptional presentation, written and verbal communication skills

  Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)

  Rhode Island Residents Only: The salary range for Rhode Island residents is $67,800 to $133,100. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.

  *All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

  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.

• About the company

  UnitedHealth Group Incorporated is an American multinational managed healthcare and insurance company based in Minnetonka, Minnesota.

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