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Sr Provider Relations Advocate - Remote - Reside in South Louisiana

Company: UnitedHealth Group
Location: Baton Rouge
Posted on: January 13, 2022

Job Description:

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)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. -The Provider Relations Advocate role is a professional, self-directed individual who will serve as the point of contact to take in and resolve complex Operations issues the assigned Provider Account is experiencing, proactively educate on new products and programs, bring actionable data and tools to assist their organization with achieving their business goals, as well as anticipate challenges their organization might face, while also assisting with finding solutions by working across UHC's dynamic and matrixed organization for assigned UHC Strategic and Core Provider Accounts in conjunction with their Affiliates representing UHC's top revenue generating contracts. - The Provider Advocate will be the assigned single point of contact for the Healthcare Professional's organization representing both government and commercial products to build and improve physician and practice manager satisfaction for UHC. This externally focused position will maximize the providers' ability to - interact with UHC through both pre-scheduled engagements with the Healthcare Professional's organizational representative to discuss new and upcoming changes occurring within UHC that will impact their specific account, discussing the Healthcare Professional's organizational service issues, while also enaging on an ad hoc basis as the Advocate either identifies or learns of a trending issue that might impact any of their assigned accounts. - The Provider Advocate works across the organization to better understand if any intiatives or issues might impact their assigned Provider Account, and while a pipeline of initiatives with tentative rollout timelines exists, the Provider Relations Advocate will have ownership of ensuring applicability of the various initiatives as it relates to their assigned Provider Accounts and have the autonomy to determine how best to engage ensuring their assigned Account has what they need to be successful.This role will develop and execute the Chart Retreival/Chase engagement strategy with key Provider Accounts; itdenifying and collaborating with key stakeholders of our largest Providers. Leaning on industry knowledge, built relationships and marketing savvy, the role will educate key Provider accounts on the benefits of the Retreival program to gain alignment and participation. In this work, the role with partner with the UHN Contracting team and OptumHealth to execute the enterprise's strategy; focusing on the risk adjustment and audit components of the Chart Retrievial/Chase work. If you are located in South Louisiana, you will have the flexibility to telecommute* as you take on some tough challenges. -Primary Responsibilities:

  • Ability to become a trusted advisor for assigned Provider Accounts through demonstration of our Cultural Values of Integrity, Compassion, Relationships, Innovation, and Performance
  • Provider Relations Advocates must possess an inherent ability to problem-solve complex and novel issues that may not have a clear path to resolution
  • To be successful, the Advocate must constantly build upon their own experience and understanding of the enterprise and have a high degree of resilience and persistence to root-cause issues and see through to resolution because standard operating procedure guidelines for most issues do not exist or are limited in scope
  • Working across dynamic/matrixed org
  • Understanding assigned Provider Account's practice management system to proactively identify issues
  • Triage and determine root cause through researching data and claims systems for all Lines of Business for of escalated claims issues impacting a provider's Accounts Receivable, including capitated requirements
  • Work across the enterprise to design and implement solutions to identified trend issues, through reporting, improvements to processing instructions, or other innovations
  • Where applicable, determine broader impact of identified root cause issues beyond the provider where the topic was initiated
  • Communicate with and educate providers on outcomes of root cause analyses, including proposed actions for the provider to improve their revenue cycle experience, including education on billing/coding errors, reimbursement policies, etc.
  • Establish proactive reporting and other initiatives to identify and take action on opportunities to minimize provider abrasion while solutions are being implemented
  • Collaborate with assigned providers on revenue-cycle based analyses of the provider's claims data to identify trends in billing, claim processing or other practices that are negatively impacting the provider's revenue cycle experience
  • Conduct live, telephonic and/or web-based meetings with providers to review findings of identified practice gaps by discuss opportunities for UHG and/or the provider to implement changes in the practice to improve the revenue cycle experience, and track progress of each agreed initiative
  • Conducts provider education via in-person, telephonic and/or web-based interactions, with individual providers and in group settings, such as Town Hall meetings, Joint Operating Committee meetings, Provider Information Expos or Mobile Service Center meetings. The educational topics will be relevant to how a provider can maximize their interaction with UHG and their revenue cycle experience. These topics can include, but are not limited to, the following: - Training on, Link and other self-service tools for existing and new provider staff; training on UHG policies such as reimbursement policies; industry changes such as new DRGs and other codes that impact a provider's revenue cycle; and ongoing training on new products, lines of business, systematic tools such as Smart edits, etc., that are implemented within the Provider Relations Advocate's provider portfolio
  • Use appropriate tracking tools and service models to escalate service issues
  • Interact with UHN and other operations areas where necessary for contract intent clarification, compliance questions, etc.
  • Make educational outreach as needed related to request from internal areas such as lines of business contacts, appeals and grievances, etc.
  • Serve as liaison between the provider and other UHG areas as needed to identify solutions for perceived revenue cycle barriers, such as clinical decisions and coding accuracy audits
  • Provide feedback and guidance to network management regarding administrative compatibility, performance, and opportunities for improvement in contractual agreements
  • Engages with enterprise business partners to identify common billing practices and educate provider to reduce office administrative burden and increase operating efficiencies
  • Position requires travel to meet with providers to support all educational needs
  • Solid self-management skills, ability to handle rapid change and an affinity for continuous learning -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:
    • Undergraduate degree in Health Administration, Business or equivalent combination of education and relevant experience
    • 3+ years of experience in health plans or provider experience, with a demonstrated focus on training, education, and/or revenue cycle work
    • 3+ years of project management expertise
    • Basic knowledge of CPT and ICD-10 coding
    • Proven customer service skills with critical thinking skills and confidence to evaluate and develop solutions
    • Proficiency with MS Office suite, SharePoint, and customer management software
    • Understanding of provider practice management
    • Integrated knowledge of UHC Data and Claims Platforms with an understanding of complex provider data record setup to enable identification of potential issues
    • Demonstrated analytical, critical reasoning and organizational skills
    • Excellent verbal and written communication skills with the ability to communicate effectively with external providers
    • Proven ability to prioritize tasks and work independently and effectively under time constraints
    • Solid interpersonal skills, experience establishing rapport and working well with internal partners Preferred Qualifications:
      • Experience in physician billing capacity, claims level audit, recovery operations experience with claims data knowledge
      • Experience with claims platforms or healthcare platforms
      • Experience working in a capitated/delegated or shared risk environment
      • Experience managing, coordinating and/or explaining complex capitated-delegated processes including cap-deductions and explanations
      • Ability to work within multiple complex technology and enterprise-wide systems To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.Careers with UnitedHealthcare. -Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do -your life's best work.(sm)*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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. - - - - -UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. - - -Job Keywords: - Senior Provider Relations Advocate, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote, South Louisiana, New Orleans, Baton Rouge, LA, Louisiana -

Keywords: UnitedHealth Group, Baton Rouge , Sr Provider Relations Advocate - Remote - Reside in South Louisiana, Other , Baton Rouge, Louisiana

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