Manager, Provider Relations - Remote

Optum Home & Community Care, part of the Optum family of businesses, is creating something new in healthcare. By bringing together industry-leading solutions, advanced technology and compassionate teams, we are building a more connected experience that helps address an individual’s physical, mental and social needs. As a team member of our Optum Care Transitions team, you’ll help patients navigate the healthcare system, access the support and services they need, and receive the right care at the right time. This meaningful work is helping improve health outcomes, expand access to care and create a more seamless health journey for the people we serve. Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

The Manager, Provider Relations, plays a key role in supporting the Director, Provider Relations and contributes to a team that spans across markets, lines of business and clients. This position is an integral part of developing and executing the Market Operations strategy and performance of the provider outcomes. This is a collaborative role requiring critical thinking skills, independence, leadership, a strategic mindset, and attention to detail.

Primary Responsibilities:

• Collaborate with Market and Clinical Operations teams to assist in service and product revenue growth and enhance stakeholder satisfaction
• Provide support to Executive Directors and the Director of Clinical Operations on network initiatives and operational priorities
• Work alongside Data Management teams to help resolve claims issues and contribute to provider performance tool improvements for multiple levels of care
• Assist in companywide initiatives by supporting efforts to market the enterprise and advance Provider Operations
• Partner with Product Teams to ensure new developments align with provider expectations and operational needs
• Compile and summarize claims-based performance data to support change management efforts at acute and PAC levels, helping create actionable recommendations that drive network performance and meet internal KPI goals
• Gather and analyze provider feedback to assist in developing action plans that improve network performance
• Support execution of strategic initiatives within the provider network by coordinating tasks and monitoring progress
• Assist in evaluating the impact of regional and national providers on market performance and provide insights to leadership
• Prepare and deliver supporting materials for presentations on provider performance tools to various audiences
• Manage provider escalation resolution processes across the market, ensuring consistent reporting and practices to reduce provider abrasion

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 health care/managed care experience
• 3+ years of provider relations and/or provider network experience
• 1+ years of experience with Medicare and Medicaid regulations
• Intermediate level of proficiency in claims processing and issue resolution
• Proficiency with MS Word, Excel, PowerPoint and Access
• Willing or ability to travel up to 55%25
• Driver’s license and access to reliable transportation

Preferred Qualification:

• Skilled Nursing provider experience

Soft Skills:

• Detail-oriented with the ability to independently plan, organize and prioritize work
• Ability to complete initiatives with minimal supervision
• Ability to build and foster relationships inside and outside the organization including C-suite level decision makers and operators
• Ability to influence and educate others
• A willingness to work toward team objectives
• Self-starter with effective communication skills
• Excellent presentation skills with high Emotional Intelligence
• Comfortable multi-tasking and operating in a matrixed organization

Work Conditions and Physical Requirements:

• Ability to establish a home office workspace
• Ability to manipulate laptop computer (or similar hardware) between office and site settings
• Ability to view screen and enter data into a laptop computer (or similar hardware) within a standard period of time
• Ability to communicate with clients and team members including use of cellular phone or comparable communication device
• Ability to remain stationary for extended time periods (1 – 2 hours)
• Ability to mobilize to and within sites within an assigned local or regional market/area, including car transport, up to 55%25 of the time

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Pay 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 $72,800 - $130,000 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 help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are 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 and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.