Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm) The Provider Relations Advocate will be a member of the Optum Virginia team responsible for developing and growing the Medicaid Skilled Nursing network and membership. The Provider Relations Advocate is responsible for the full range of provider relations and service interactions within Optum Health, 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. Provider Relations Advocates build and nurture positive relationships between the health plan, providers (Skilled Nursing Facilities), and practice managers. Responsibilities also include implementing strategies relating to the development and management of a Medicaid SNF provider network, identifying gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs, and may also be involved in identifying and remediating operational short-falls and researching and remediating claims.Primary Responsibilities:Use pertinent data and facts to identify and solve a range of problems within area of expertiseInvestigate non-standard requests and problems, with some assistance from othersWork exclusively within a specific knowledge area Prioritize and organize own work to meet deadlines Provide explanations and information to others on topics within area of expertiseThis position will cover providers from Northern to Southwestern Virginia
Required Qualification:Undergraduate degree 2+ years of provider contracting, provider relations and / or provider network experience Intermediate level of proficiency in claims processing and issue resolution 1+ years of experience with Medicare and Medicaid regulations, including knowledge of payment guidelines and reimbursement methodologies such as DRGs, RUGS, etc.Familiarity with local and national market trends in skilled nursing community and in managed care industryIntermediate level of proficiency with MS Word, ExcelAbility to travel about 75% for provider visitsPreferred Qualifications:Skilled nursing industry experienceProficiency in MS PowerPoint and AccessExperience with NDB, Cosmos Exceptional presentation, written and verbal communication skillsAbility to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from othersAbility to work independently and remain on taskStrong customer service skills and ability to manage multiple priorities and rapid changeGood organization and planning skillsAbility to prioritize and meet deadlines from multi-staff members within the department Already Fortune 6, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good. Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed. Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams. 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: organization, effective communication, Medicare, Medicaid, Provider education, network contracts, Roanoke, VA, Lynchburg, VA, Blacksburg, VA, Virginia
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.