Provider Engagement Representative - Remote

Primary Responsibilities

• Develop and maintain overall UnitedHealthcare business relationships with Skilled Nursing Facilities & Assisted Living Facilities
• Designs and implements programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.) and business office managers.
• Direct and implement strategies relating to the development and management of a provider network.
• Support all education opportunities on UnitedHealthcare businesses which include in person and telephonic interactions.
• Identifies gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs.
• Lead and/or support external facing Account and business review meetings with key Skilled Nursing Facility staff to review financial performance, contract methodology, and reimbursement opportunities.
• Provide explanations and information to others on topics within area of expertise.
• Identify ancillary provider gaps, and support contracting of new providers in areas where needed.
• Prioritize and organize own work to meet deadlines cross functionally within the organization.
• Investigate non-standard requests and issues, prior to escalation if needed.
• Support Post-Acute Priorities
• ISNP and IE-SNP Business Development - assist with planned growth initiatives for ISNP/IE-SNP business.
• Education and Training to facilities on Medication Adherence requirements for members.
• Provide outreach and education on updated policies, new initiatives, performance, and others as necessary.

Required Qualifications

• 2+ years of provider relations or provider network management experience
• 1+ year of experience with Medicare/Medicaid regulations
• Intermediate level of proficiency with MS Word, Excel, PowerPoint and, Outlook
• Driver's License and access to a reliable transportation
• Ability to travel 25% of the time within the CT area

Preferred Qualifications

• Experience working in a Skilled Nursing or Assisted Living Facility
• Experience with claims processing and issue resolution
• Familiarity with claims processing and issue resolution