Provider Relations Representative

Posted Yesterday
Be an Early Applicant
San Bernardino, CA, USA
In-Office
60K-90K Annually
Junior
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Serve as the single point of contact between Optum and IPA physicians, providing education, support, training and troubleshooting. Monitor PCP performance, develop and implement action plans with IPA leadership, escalate and resolve issues, drive membership growth and retention, and maintain collaborative office relationships. Position requires regular travel within Riverside County (≈50%).
Summary Generated by Built In
Requisition Number: 2376398
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.
As a Provider Relations Representative at Optum, you will act as a direct interface between Optum and the affiliated physicians in Optum's Independent Physician Association (IPA) network and support their operations and performance success. This position provides continuous education, support, training and troubleshooting to physicians and their staff.
This position will require regular travel across Riverside County.
Primary Responsibilities:
  • Serve as single-point-of-contact to the physician network and is an accountable owner, responsive to physician needs. Knowledgeable about incentive programs, contract reimbursement, Optum's internal processes and priorities, and other Optum initiatives, as applicable
  • Monitors performance of assigned PCPs, identifies low performing PCPs and works with IPA leadership to develop action plan for specific metrics needing improvement. Works with office to effectuate action plans and monitors progress
  • Intervenes and escalate issues as appropriate
  • Maintains awareness of providers interested in further engaging with Optum on new business opportunities (contracts and business combinations), and on shifting market/competitive dynamics that would impact the IPA
  • Works collaboratively with offices and Optum growth team to drive membership growth and retention
  • Responds timely (within one business day) to provider issues, works with other groups/central departments to resolve issues and updates providers and office staff regularly through to resolution
  • Build collaborative relationships with IPA physicians and their office staff

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:
  • 2+ years of health care/managed care experience
  • 2+ years of provider relations and/or provider network experience
  • Intermediate level of proficiency in claims processing and issue resolution
  • Proficiency with Microsoft Office Suite
  • Able and willing to travel 50% within assigned territory

Preferred Qualification:
  • Provider recruitment and contracting experience

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $90,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
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.
OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Skills Required

  • 2+ years of health care/managed care experience
  • 2+ years of provider relations and/or provider network experience
  • Intermediate level proficiency in claims processing and issue resolution
  • Proficiency with Microsoft Office Suite
  • Able and willing to travel 50% within assigned territory
  • Provider recruitment and contracting experience
  • Pass a pre-employment drug test

What the Team is Saying

Optum Compensation & Benefits Highlights

  • Leave & Time Off Breadth PTO accrues each pay period with eight paid U.S. holidays plus a floating holiday, and generous time away is consistently emphasized. This breadth supports planned and unplanned time off beyond standard vacation days.
  • Parental & Family Support Six weeks of paid parental leave, up to two weeks of paid caregiver leave, Bright Horizons back‑up care, and adoption assistance signal strong family-oriented support. EAP access with counseling sessions further extends help to employees and their households.
  • Wellbeing & Lifestyle Benefits Company‑paid short‑ and long‑term disability, Calm app membership, tuition reimbursement, commuter and FSA accounts, and broad employee discounts expand everyday wellbeing resources. Free or low‑cost virtual visits complement these lifestyle supports.

Optum Insights

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

What We Do

Optum, part of the UnitedHealth Group family of businesses, is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

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Optum Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.

Typical time on-site: Not Specified
HQEden Prairie, MN
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