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Provider Relations Advocate - Corpus Christi, TX

Company: UnitedHealth Group
Location: Corpus Christi
Posted on: January 12, 2022

Job Description:

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.(sm)
The Provider Relations Advocate is responsible for developing, maintaining and servicing a high quality, marketable and satisfied provider network within an assigned geographic area. -Key responsibilities include recruitment and contracting, education and servicing of assigned providers. -The Provider Relations Advocate helps assigned Providers operate successfully within our healthcare delivery model by providing strategic planning and tools to meet goals. -This position is expected to build and sustain strong working relationships with cross functional departments, vendors, local sales, and assigned Providers. The Provider Relations Advocate is accountable for overall performance and success for their assigned groups as well as ownership and oversight to provide redirection as appropriate.
This position will be expected to travel throughout the Corpus Christi, TX area regularly.
Primary Responsibilities:
Ensures Providers have in depth understanding of WellMed Model of Care to include, but not limited to, contractual obligations, program incentives and patient care best practices
Conduct detailed analysis of various reports by tracking and trending data to develop a strategic plan to ensure performance goals are achieved
Ensures the overall strategic plan incorporates interventions with internal departments or subject matter experts, external vendors, and others as needed
Participates in creation and execution of a local network development plan to assure network adequacy as needed
Works at the direction of their assigned leader to recruit/contract providers ensuring network adequacy
Regularly meets with cross functional team to create, revise and adjust strategy for assigned Provider Groups to meet overall performance goals
Conducts new provider orientations and ongoing education to providers and their staffs on healthcare delivery products, health plan partnerships, processes and compensation arrangements
Maintains open communication with providers to include solutions for resolution and closure on health plan issues related to credentialing, claims, eligibility, disease management, utilization management, quality and risk adjustment programs
Conducts provider meetings to share and discuss economic data, troubleshoots for issue resolution, and implements an escalation process for discrepancies
Collaborates with provider groups to develop, execute and monitor performance and patient outcomes improvement plans
Collaborates with Medical Director to monitor utilization trends
Handles or ensures appropriate scheduling, agenda, materials, location, meals and minutes of provider meetings as needed
Represent WellMed/UHG by holding company sponsored Provider events (Summits, Virtual Town Hall Events, Learning Sessions)
Provider support to maintain and develop ongoing value related to the WellMed Value Proposition
Introduce and advocate company resources to facilitate practice optimization
Identifies at risk situations and develops a plan for escalation and corrective action
Performs all other related duties as assigned

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:
Associate's degree in related field or 2+ additional years of comparable work experience beyond the required years of experience may be substituted in lieu of an Associate's degree
1+ years of provider relations or managed care experience
Willingness to travel throughout the Corpus Christi area regularly
Knowledge of local provider community
Experience interfacing effectively both internally and externally with a wide range of people including physicians, office staff, hospital executives and other health plan staff
Willingness to travel throughout the Corpus Christi -area regularly
Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance

Preferred Qualifications:
Bachelor's Degree with a significant understanding of medical care financing and delivery systems, provider contracting, reimbursement arrangements and network management
Presentation skills to small and large groups
Professional provider relations experience involving physicians and administrative staff
Provider recruitment and contracting experience
Analytical and problem solving experience with effective follow through
Physical & Mental Requirements:
Ability to lift up to 25 pounds
Ability to push or pull heavy objects using up to 25 pounds of force
Ability to sit for extended periods of time
Ability to stand for extended periods of time
Ability to use fine motor skills to operate office equipment and/or machinery
Ability to properly drive and operate a company vehicle
Ability to receive and comprehend instructions verbally and/or in writing
Ability to use logical reasoning for simple and complex problem solving

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 WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)
WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.
For more information on our Internal Job Posting Policy, click here.

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

Job Keywords: Provider Relations Advocate , Provider Relations, Physician Relations, Advocate, Managed Care, Relationships, Travel, Contracting, Reimbursement, Network Management, Recruitment, Corpus Christi, TX, Texas

Keywords: UnitedHealth Group, Corpus Christi , Provider Relations Advocate - Corpus Christi, TX, Other , Corpus Christi, Texas

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