Senior Provider Relations Advocate - South Riverside County, CA

13 Jul 2024
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For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.Optum’s Pacific West region is redefining health care with a focus on health equity, affordability, quality, and convenience. From California to Oregon and Washington, we are focused on helping more than 2.5 million patients live healthier lives and helping the health system work better for everyone. At Optum Pacific West, we care. We care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions.As a Provider Relations Advocate at Optum, you will act as a direct interface between Optum and the affiliated physicians in Optum’s Independent Physician Association (IPA) network and support their operations and performance success. This position provides continuous education, support, training and troubleshooting to physicians and their staff.The main office for this position will be in Murrieta, CA; this position will require regular travel across South Riverside County to include Murrieta, Hemet, Temecula, Lake Elsinore, Wildomar, Menifee.Primary Responsibilities:

Serve as single-point-of-contact to the physician network and is an accountable owner, responsive to physician needs. Knowledgeable about incentive programs, contract reimbursement, Optum’s internal processes and priorities, and other Optum initiatives, as applicable

Monitors performance of assigned PCPs, identifies low performing PCPs and works with IPA leadership to develop action plan for specific metrics needing improvement. Works with office to effectuate action plans and monitors progress

Intervenes and escalate issues as appropriate

Maintains awareness of providers interested in further engaging with Optum on new business opportunities (contracts and business combinations), and on shifting market/competitive dynamics that would impact the IPA

Works collaboratively with offices and Optum growth team to drive membership growth and retention

Responds timely (within one business day) to provider issues, works with other groups/central departments to resolve issues and updates providers and office staff regularly through to resolution

Build collaborative relationships with IPA physicians and their office staff

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:

2+ years of health care/managed care experience

2+ years of provider relations and/or provider network experience

Experience with Medicare and Medi-Cal regulations

Understanding of healthcare systems billing

Intermediate level of proficiency in claims processing and issue resolution

Proficiency with Microsoft Office Suite

Able and willing to work a hybrid schedule (in the office 3 days per week when not in the field)

Able and willing to travel 50% within assigned territory

Located within South Riverside County, CA

California Residents Only: The salary range for this role is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.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.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.

Full-time
  • ID: #52093940
  • State: California Temecula 92589 Temecula USA
  • City: Temecula
  • Salary: USD TBD TBD
  • Showed: 2024-07-13
  • Deadline: 2024-09-12
  • Category: Et cetera
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