Position Description: Energize your career with one of Healthcare's fastest growing companies. You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up. This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 17 leader. Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.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.The Credentialing Representative is responsible for activities associated with credentialing or re-credentialing physicians and providers, including processing provider applications and re-applications including initial mailing, review, and loading into the database tracking system ensuring high quality standards are maintained.Credentialing Representatives will assist with audits and provide feedback to reduce errors and improve processes and performance.Positions in this function are responsible for all activities associated with credentialing or re-credentialing physicians and providers. Includes: processing provider applications and re-applications including initial mailing, review, and loading into the database tracking system ensuring high quality standards are maintained. Conducts audits and provides feedback to reduce errors and improve processes and performance.Primary Responsibilities:Apply knowledge / skills to a range of moderately complex activitiesDemonstrate great depth of knowledge / skills in own functionSometimes act as a technical resource to others in own functionProactively identify solutions to non-standard requestsSolve moderately complex problems on ownWork with team to solve complex problemsPlan, prioritize, organize and complete work to meet established objectivesMay coordinate work of other team members
Required Qualifications:High School Diploma / GEDProvider credentialing experience or healthcare experienceDatabase skills including querying, reporting, and document generationInformational research skillsPrevious experience in a production based environmentPreferred Qualifications:Experience working with compliance workflows and processes including NCQA policies and practicesExperience in researching and applying government regulatory informationSoft Skills:Ability to manage multiple tasks and triage responsibilitiesPeople skills and effective communicatorCareers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So, when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work. 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: Credentialing Representative
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.