Provider Engagement Representative - Remote in Michigan

Primary Responsibilities

• Develop and maintain overall UnitedHealthcare business relationships with Skilled Nursing Facilities
• Serve as the primary point of contact for assigned facilities ensuring timely and effective communication
• Conduct routine outreach (virtual and on-site) to assess provider needs, concerns, and satisfaction
• Design and implement programs to build and nurture positive relationships between the health plan, nursing facility providers and business office managers
• Support the development and management of a provider network
• Support all education opportunities on UnitedHealthcare businesses which include in person and telephonic interactions
• Identify gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs
• Provide explanations and information to others on topics within area of expertise
• Prioritize and organize own work to meet deadlines cross functionally within the organization
• Investigate non-standard requests and issues, prior to escalation if needed
• Compass Data Base - update & maintain regularly with information following interactions with nursing facilities
• Outreach and education on updated policies, new initiatives, performance, and others as necessary

Required Qualifications

• 2+ years of experience with Medicare/Medicaid regulations
• Experience working in a skilled nursing facility
• Billing experience in a skilled nursing facility
• Demonstrated intermediate level of proficiency with MS Word, Excel, PowerPoint and, Outlook
• Driver's License and access to reliable transportation
• Ability to travel 25% of the time within Michigan

Preferred Qualifications

• 2+ years of provider relations or provider network management experience
• Demonstrated familiarity with claims processing and issue resolution