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Provider Relations Advocate

UnitedHealth Group

Corpus Christi, TexasMid$60.2k – $107.4k/yr
Sign in to applyVerified 1h ago
Location
Corpus Christi, Texas
Work model
On-Site
Level
Mid
Salary
$60.2k – $107.4k/yr

About this role

Explore opportunities with WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will be part of a team who shares your passion for helping people achieve improved health outcomes. Explore rewarding opportunities for physicians, clinical staff and non-patient-facing roles. Join us and discover the meaning behind Caring. Connecting. Growing together. The Physician Business Manager with WellMed is responsible for developing, maintaining, and servicing a high quality, marketable, and satisfied provider network within an assigned geographic area. The Physician Business Manager 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 solid working relationships with cross functional departments, vendors, local network, and assigned providers. The Physician Business Manager is accountable for overall performance and profitability for their assigned groups, as well as ownership and oversight to provide redirection as appropriate. Location: 3434 Saratoga Blvd. Corpus Christi, TX 78415. Will require 50-75% travel (with mileage reimbursement) to meet with providers. Schedule: Monday-Friday, 8am-5pm CST.

Primary Responsibilities

Educate providers to ensure that they have the tools they need to meet quality, risk adjustment, growth (as appropriate), and total medical cost goals per business development plans Ensure 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 Ensure the overall strategic plan incorporates interventions with internal departments or subject matter experts, external vendors, and others, as needed Participate in creation and execution of a local network development plan to assure network adequacy as needed Conduct new provider orientations and ongoing education to providers and their staff on healthcare delivery products, health plan partnerships, processes, and compensation arrangements Maintain 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 Conduct provider meetings to share and discuss economic data, troubleshoot for issue resolution, and implement an escalation process for discrepancies Collaborate with provider groups to develop, execute, and monitor performance and patient outcomes improvement plans Collaborate with Medical Director to monitor utilization trends and profit pools and share results with assigned PCPs Handle or ensure appropriate scheduling, agenda, materials, location, meals, and minutes of provider meetings as needed Collaborate with contracting team to ensure provider data is correct and provider directories include any needed updates Complete Practitioner Data Forms and Provider Change Forms as needed Represent WellMed/UHG by holding company sponsored provider events (summits, learning sessions) Provide information and participate in management meetings as requested Regularly meet with cross functional team to create, revise, and adjust strategy for assigned provider groups to meet overall performance goals Provide support to maintain and develop ongoing value related to the WellMed Value Proposition Introduce and advocate company resources to facilitate practice optimization Ability to travel as needed 50 - 75% within market What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their

Listing verified 1h ago. Applications go through the company's official careers site.

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Provider Relations Advocate at UnitedHealth Group, Corpus Christi, Texas | Yoinka