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External Provider Relations Representative - TX

Company: UnitedHealth Group
Location: Austin
Posted on: September 24, 2022

Job Description:

Careers at Managed Care of North America, Inc. (MCNA), part of the UnitedHealthcare and UnitedHealth Group family of businesses. MCNA is a leading dental benefits administrator dedicated to promoting high quality and cost-effective oral health. We provide services to state agencies and managed care organizations for Medicaid, Children's Health Insurance Program (CHIP) and Medicare members. We also offer commercial plans for private employers, individuals and families. Join our team and help us make dental care more accessible to everyone. Our career opportunities span across different job categories and specializations, requiring a varying level of skills. Working with us means being part of a stable organization with meaningful purpose that will support your personal and professional development. This is an opportunity to make a difference in the lives of others while growing your career with a company that services over 8 million people. Become part of a team that has a passion for excellence and start doing your life's best work.(sm)The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This Provider Relations Advocate role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. We're building better, more effective provider networks every day. In this role, 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.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
  • Are you ready for a challenge? You'll be part of a performance driven, fast paced organization that is serving multiple markets and you'll be charged with educating and building relationships with providers to evolve ongoing processes and programsYou'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 work experience
    • 4+ years of health care/managed care experience
    • 2+ years of provider relations and/or provider network experience
    • 1+ years experience with Medicare and Medicaid regulations
    • Intermediate level of proficiency in claims processing and issue resolution
    • Proficiency with MS Word, Excel, PowerPoint and Access
    • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodationPreferred Qualification:
      • Undergraduate degree -To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employmentCareers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)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.

Keywords: UnitedHealth Group, Austin , External Provider Relations Representative - TX, Other , Austin, Texas

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