Manager of Provider Service and Advocacy - Telecommute in the Nebraska Region

UnitedHealthcare Remote
manager advocacy telecommute health providers provider relations relations training regulations operational management compliance advocacy

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

The Manager of Provider Relations Service & Advocacy is responsible for the full range of provider relations and service interactions within UnitedHealth Group, including working on end-to-end provider claim and call quality, ease of use of physician portal and future service enhancements, and training & development of external provider education programs. Managers of Provider Relations Service & Advocacy design and implement programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Responsibilities also include directing and implementing strategies to communicate and advocate providers' needs to internal stakeholders in order to drive creation of solutions that meet our mutual business goals, develop resources and programs to assist and educate providers (e.g., web-based training; FAQ document), and may also be involved in identifying and remediating operational short-falls and researching and remediating claims.

If you are located in the Nebraska Region , you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Provides assistance with project management or problem solving related to UHCS products and services as needed
  • Ensure United Healthcare Networks partners understand UHCS requirements and commitments in state contracts through collaboration with UHN and UHCS leadership
  • Adapt departmental plans and priorities to address business and operational challenges
  • Influence or provide input to Health Plan forecasting and planning activities
  • Product, service or process decisions are most likely to impact multiple groups of employees and/or customers (internal or external)
  • Track and trend provider issues and concerns and elevate within UHN and C&S for resolution
  • Assist with monthly and quarterly State reports as needed
  • Organize and deliver all provider education, communications, and outreach initiatives
  • Manage some Association relationships
  • Develop and deliver presentations for key provider meetings throughout the year
  • Develop and deliver provider trainings as needed including Network Bulletins and other collateral
  • Identify operational issues and seek assistance from appropriate functional areas for resolution
  • Coordinate giveaways and collateral for provider events
  • Maintain PR SharePoint site used for tracking outreach initiatives
  • Develop and maintain databases used for outreach, surveys, tracking
  • Provide on-boarding and orientation to new providers (e.g., ensure providers take on-line training; provide instruction on processes
  • Provides to compliance provider informational training materials for submission to State Regulatory Agency

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:

  • Undergraduate degree
  • 5+ years of provider relations and/or network management experience
  • 5+ years of professional Word, PowerPoint, and Excel
  • 5+ years of experience with Medicare and Medicaid regulations
  • 5+ years of experience with Medicare and Medicaid regulations
  • 3+ years of management experience, team/project leadership or mentoring
  • General level of knowledge of claims/systems processes, contracting and reimbursement methodologies
  • Ability to travel required across the State of NE as needed
  • Ability to understand the challenges providers face and provide appropriate solutions as needed

Preferred Qualifications:

  • Ability to work independently and remain on task
  • Ability to prioritize and meet deadlines from multi-staff members within the department
  • Good organization and planning skills
  • Exceptional presentation, written and verbal communication skills
  • 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 accommodation

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 employment.

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)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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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