Provider Relations Manager - Remote within - GA, FL,MD, VA, NC, SC only

UnitedHealth Group

  • Greensboro, NC
  • $89,900-160,600 per year
  • Permanent
  • Full-time
  • 2 days ago
Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere.As a team member of our Senior Community Care (SCC) product, we work with a team to provide care to patients at home in a nursing home, assisted living for senior housing. This life-changing work adds a layer of support to improve access to care.We're connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together.It's a big step forward when you realize that you've earned the trust to lead a team. Now, let's determine just how big that step can be. Take on this managerial role with UnitedHealth Group and you'll be part of a team that's reshaping how health care works for millions. We're driving ever higher levels of sophistication in how provider networks are formed and operate. The goal is to improve quality of service while exploring new ways to manage costs. Here's where you come in. You'll use your solid customer service and leadership skills to ensure quality of interactions and performance of providers in our networks. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 5 leader.Provider Engagement Manager (PEM) position will provide management and direction for Provider Engagement Representatives (PERs) for GA, FL,MD, VA, NC, SC ISNP markets and MI, WV non ISNP markets as well as the business relationships for contracted Skilled Nursing Facility (SNF) providers for all UHC lines of business.You will collaborates enterprise wide with other business units (E.g., Care Transitions, Optum Health, plan leadership) and provides critical support for Institutional Special Needs Plan (ISNP) growth, affordability, and quality.If you are located within the following states - GA, FL, MD, VA, NC, SC, you will have the flexibility to work remotely* as you take on some tough challenges.Primary Responsibilities:
  • Oversees the facilitation and coordination of Business Review Meetings, Joint Operating Committee, and Provider
  • Engagement Meetings for Senior Community Care (SCC)
  • Directs and implements strategies relating to the development and management of provider network
  • Identifies gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs
  • Identifies and remediates operational issues and remediating claims
  • Set team direction, resolve problems and provide guidance to members of own team
  • Adapt departmental plans and priorities to address business and operational challenges
  • Drive the design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers
  • Ensure implementation of training and education programs for external providers
It's time to step up to some real challenge. You'll be part of a performance driven, fast paced organization that is serving multiple markets and you'll be managing and mentoring a production based team to meet aggressive goals.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:
  • 5+ years of provider relations experience
  • 1+ years of experience with Medicare and Medicaid regulations
  • Intermediate level of knowledge of claims processing
  • Intermediate in MS Word, PowerPoint, and Excel
  • Proven exceptional presentation, written and verbal communication skills
Preferred Qualification:
  • 2+ years of supervisory experience
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter PolicyPay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

UnitedHealth Group