Provider Relations Advocate/Enrollment Specialist, Spokane, WA at Spokane

Job 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 lifes best work.The Provider Relations Advocate/Enrollment Specialist is responsible for provider relations and service within UnitedHealth Group as well as enrollment support for the United HealthCare Nursing Home Plan in the Spokane area. This position will require meeting with prospective enrollees responsible parties/families to explain the advantages of the clinical model and the health plan, and to complete enrollments in a compliant manner. Additionally, this position will be assigned to work with contracted nursing homes in Spokane to assist with resolution of provider claim and service issues, provider portal questions, and be able to develop and provide training for our nursing home partners. This position will build and nurture positive relationships between the health plan and assigned skilled nursing facilities. Responsibilities include education of the nursing home staff as to the operational and financial aspects of working with the health plan, identifying and remediating operational short-falls, and researching and remediating claims. This position will also be a representative for Optum and the United Healthcare Nursing Home Plan in the Spokane area.In this role you will be expected to: Use pertinent data and facts to identify and solve a range of problems within area of expertise. Investigate non-standard requests and problems, with some assistance from others. Work exclusively within a specific knowledge area . Prioritize and organize own work to meet deadlines. Provide explanations and information to others on topics within area of expertise. This position is for both sales and provider relations. The individual will need to be licensed for Medicare sales as well as able to address claims and other provider relations support for nursing homes. This position will not be commission based.

Job Requirements

Requirements: Undergraduate degree (preferred) Life and Disability License ( Washington state) 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 (preferred). Exceptional presentation, written and verbal communication skills. Ability to work independently and remain on task. Good organization and planning skills. Ability to prioritize and meet deadlines from multi-staff members within the department. Intermediate level of proficiency with MS Word, Excel, and PowerPointOptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.OptumHealth helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their health care needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.At OptumHealth, you will perform within an innovative culture thats focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact thats greater than youve ever imagined.Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VUnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Country: USA, State: Washington, City: Spokane, Company: UnitedHealth Group.