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Provider Relations Manager - Remote from Little Rock, AR area




Little Rock, Arkansas, United States

naviHealth, part of Optum and the UnitedHealth Group family of businesses, combines the talents of our dedicated staff and leading-edge technology to deliver compassionate care to seniors nationwide. With millions of lives touched, we are innovating the way health care is delivered from hospital to home so seniors can lead more fulfilling lives. A career with us means making an impact in the lives of those we serve, including vulnerable populations who benefit from care that is more efficient, more effective and more human. Our environment empowers our team members to elevate our interactions with each other and the experiences we deliver to our patients, giving them more days at home. Join our team, it’s your chance to improve the lives of millions while doing your life’s best work.(sm)

Why naviHealth?

At naviHealth, our mission is to work with extraordinarily talented people who are committed to making a positive and powerful impact on society by transforming health care. naviHealth is the result of almost two decades of dedicated visionary leaders and innovative organizations challenging the status quo for care transition solutions. We do health care differently and we are changing health care one patient at a time. Moreover, have a genuine passion and energy to grow within an aggressive and fun environment, using the latest technologies in alignment with the company’s technical vision and strategy.

A highly engaged provider network is critical to ensure members receive the right care at the right place for the right amount of time. The Provider Relations Manager develops and maintains an ongoing collaborative relationship with providers, based on mutual respect, high-quality outcomes, and patient satisfaction. The role works to continually shape the network landscape, by offering objective data and education to all stakeholders in the market. In its highest functional state, it’s the Provider Relations Manager who supports the provider in ensuring recognition by the hospital and plan partners through appropriate rate setting, improved volume and achieving and maintaining PAR/Contracted status. Ultimately the Provider Relations Manager plays a vital role in achieving positive outcomes in the market including but not limited to: SNF LOS, discharges to PAR/contracted providers and closing clinical records.

If you reside in the Little Rock, AK area, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

  • Develop relationships with providers/payers and support the patient-centric model during new implementations
  • Create and maintain a database of pre-implementation provider metrics (e.g. readmission rates, LOS, etc.)
  • Coordinate implementation activities (scheduling dates/locations, speakers/attendees, contact points, deck preparation, status updates, etc.)
  • Create provider facing educational and summary documents
  • Ensure all necessary logistics are obtained to support a successful implementation (contacts, EMR access, onsite access, etc.)
  • Coordinate onsite requirements for naviHealth colleagues (e.g. credentialing, legal requirements, etc.)
  • Maintain positive working relationships with providers/payers to build a high quality, highly receptive network base in mature markets
  • Serve as the main point of contact for providers
  • Deliver provider and hospital performance information at a regular cadence
  • Hold providers accountable for professional collaboration (based on collaboration agreement), timely delivery of clinical information, supporting patient and family access to the naviHealth Care Coordinator
  • Evaluate provider receptiveness and quality
  • Lead network issue resolution
  • Proactively identify challenging situations and ensure appropriate action is taken to mitigate escalation
  • Support providers and respond to questions, concerns, and suggestions
  • Solicit feedback as appropriate (focus groups, survey, coalitions)
  • Work to resolve provider complaints at local, regional, and national levels
  • Develop ongoing support materials for providers
  • Analyze and prepare dashboards for providers
  • Coordinate and deliver dashboard information to providers (SNF and hospital as indicated)
  • Provide ongoing education to providers that promote quality service and collaboration
  • Work closely with market presidents and senior clinical managers to monitor and improve hospital DC referral patterns, par and non-par SNF LOS, and closed record statistics
  • Report challenges with care coordinators in the field
  • May participate in network narrowing strategies
  • Work closely with provider relations leadership
  • Analyze data for trends in performance at the market, client, regional, and national level
  • Support new and existing strategic network initiatives and programs and communicate to providers
  • Support naviHealth brand marketing
  • Support the onboarding of new network colleagues through mentorship
  • Work with internal resources on the development of preferred provider networks
  • Support and implements pay for value programs, as applicable
  • Assist with contracted network development, as assigned
  • Perform other duties and responsibilities as required, assigned, or requested

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:

  • Bachelor’s degree or equivalent work experience
  • Experience in managed care, health plan operations, provider contracting, customer service, or provider relations
  • Experience in Acute and Post-Acute Care Continuum
  • Proficiency with Microsoft Office applications
  • Ability to travel up to 50% within the State of Arkansas & Oklahoma City, OK

Preferred Qualifications:

  • Experience in a provider-facing or account management role
  • Data analytics and reporting experience
  • Experience and ability to build and foster relationships inside and outside the organization
  • Proven effective negotiation and influencing skills
  • Proven detail-oriented
  • Proven ability to independently plan, organize and prioritize work
  • Demonstrates willingness to work toward team objectives
  • Ability to make appropriate organizational determinations in accordance with naviHealth standards of practice independently and timely
  • Proven solid brand promotion and management skills

About naviHealth

Being a pioneer in post-acute management and care transitions with 19 years of experience, naviHealth is uniquely positioned to manage patients, improve clinical and financial outcomes, and share risk with payors and providers. We provide clinical service support alongside proprietary technology and advisory solutions that empower health systems, health plans and post-acute providers to navigate care episodes across the continuum, with the goal of reducing waste and improving patient outcomes.

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

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

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.