Full Job Description
ProHealth Physicians, part of OptumCare
If you want to get way ahead in your career, it makes sense to be with an organization's that's way ahead of the curve. Formed in 1997, ProHealth Physicians has grown to become Connecticut’s leading primary care physician organization. With over 90 locations throughout the state of Connecticut, our family of primary care doctors and specialists care for more than 360,000 people statewide. In fact, ProHealth serves every county and provides roughly ten percent of the primary care delivered to patients in the state. We're leaders in thinking and in serving our communities. For instance, we're a C.M.S. approved Accountable Care Organization (ACO), covering over 30,000 Medicare patients associated with our community-based primary care providers. We're also nationally recognized as a NCQA Level III Medical Home. That kind of progressive leadership makes us perfect fit for OptumCare and UnitedHealth Group's expanding family of providers. This is a place where you can stay way ahead as you do your life's best work.(sm)
The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This Provider Relations Advocate role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. We're building better, more effective provider networks every day. In this role, you'll use your strong customer service orientation and knowledge of insurance claims to serve as an advocate for providers in our networks. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 6 leader.
The address to this location is 3 Farm Glen Road Farmington, CT.
Assist in end-to-end provider claims and help enhance call quality
Assist in efforts to enhance ease of use of physician portal and future services enhancements
Coordinate Provider Roster Management updates
Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers
Support development and management of provider networks
Help implement training and development of external providers through education programs
Identify gaps in network composition and services to assist network contracting and development teams
Are you ready for a challenge? You'll be part of a performance driven, fast paced organization that is serving multiple markets and you'll be charged with educating and building relationships with providers to evolve ongoing processes and programs.
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.
High school diploma or equivalent work experience
4+ years of health care/managed care experience
2+ years of provider relations and/or provider network experience
Intermediate level of proficiency in claims processing and issue resolution
1+ years’ experience with Medicare and Medicaid regulations
Proficiency with MS Word, Excel, PowerPoint and Access
The health system is moving ahead. You can too as you help us build new levels of provider network performance. Join us. Learn more about how you can start doing your life's best work.(sm)
OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare’s support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment