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Manager of Employment and Community First (ECF) Provider Services - Brentwood, TN

UnitedHealth Group


Location:
Brentwood, TN
Date:
05/26/2017
Job Code:
1739038
Apply on the Company Site
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Job Details


Manager of Employment and Community First (ECF) Provider Services - Brentwood, TN(Job Number:710553)
Description

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)

 

Positions in this function are accountable for the full range of provider relations and service interactions within UHG, 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. Designs and implements programs to build and nurture positive relationships between the health plan, providers, and practice managers.

 

Directs and implements strategies relating to the development and management of the CHOICES and ECF CHOICES provider networks. Identifies gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs. Also involved in identifying and remediating operational short-falls and researching and remediating claims.

 

Educates and assists CHOICES and ECF CHOICES long term care providers, and the Fiscal Employer Agent (FEA) regarding appropriate claims submission processes and requirements, coding updates, electronic claims transactions and electronic funds transfer; development and maintenance of provider manuals, website, fee schedule, etc.; provides technical assistance regarding claims submission and resolution processes; and ensures prompt resolution of claims issues or inquiries.

 

Develop strategies to assess the effectiveness of claims education and technical assistance activities, gather feedback regarding the extent to which CHOICES and ECF CHOICES long term care providers are informed about appropriate claims submission processes and practices, and identify trends and guide the development of strategies to improve the efficiency of claims submission and resolution processes, as well as provider satisfaction.

 

Primary Responsibilities:

  • Management and development of a high-functioning team of three ECF Provider Advocates (25% of time)
  • Collaborating with internal business leaders to drive issue resolution and process improvement (25% of time)
  • Meeting and communicating with senior provider, provider association, and government leaders to assess issues and ensure end-to-end resolution of escalated issues (25% of time)
  • Leading significant program and process implementations including technology implementations, benefit changes, and large-scale contracting efforts (25% of time)

 


Job Provider Relations and Service
Primary Location US-TN-Brentwood
Other Location 
Organization C&S Tennessee ABD LTC
Schedule Full-time
Number of Openings 1
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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