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Sr. Provider Relations Operations Advocate - Omaha, Nebraska

UnitedHealth Group


Location:
Omaha, NE
Date:
09/05/2017
2017-09-052017-10-04
Job Code:
1780514
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Job Details


Sr. Provider Relations Operations Advocate - Omaha, Nebraska(Job Number:728370)
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)

The Senior Provider Relations Operations Advocate is responsible for the full range of provider relations and operations tasks, including working on end-to-end provider claim and call questions and projects. Identify opportunities for ease of use of physician portal and future service enhancements, and training & development of external provider education programs.

 

Senior Provider Relations Operations Advocates 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 relating to the development and management of a provider network, and identifying gaps in network composition and services to assist the network contracting. The will be involved in reporting,  and may also be involved in identifying and remediating operational short-falls and researching and remediating claims.

 

Primary Responsibilities:

  • Assess and interpret customer needs and requirements
  • Identify solutions to non - standard requests and problems.- Solve moderately complex problems and/or conduct moderately complex analyses
  • Work with minimal guidance; seek guidance on only the most complex tasks
  • Translate concepts into practice
  • Provide explanations and information to others on difficult issues
  • Coach, provide feedback, and guide others
  • Act as a resource for others with less experience
  • Impact of work is most often at the team level

Coordinates, supervises and is accountable for the daily activities of business support, technical or production team or unit. Assists in resolution of State concerns, implements new State regulation as pertains to Network. Handles Network operation functions to meet State requirements, duties include but not limited to: Develops reports to meet State requirements, Member notification process, Access and Availability monitoring, PCP Panel monitoring, PCP transfers, Provider load issues, State Provider file, Encounter submissions. Provides oversight for vendor management that include, Vision, Pharmacy, Transportation, Radiology Prior Authorization, Access & Availability, and UHG segment management. 

 


Job Provider Relations and Service
Primary Location US-NE-Omaha
Other Location US-NE-Lincoln
Organization C&S Nebraska
Schedule Full-time
Number of Openings 1
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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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