Sr Provider Relations Liaison - Comm. Network Operations - Pearland Admin Office - Kelsey Seybold Clinic

Requisition Number: 2378340
Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.
The Senior Provider Relations Liaison is responsible for establishing and maintaining solid positive business relationships with current and potential Kelsey-Seybold and KelseyCare Advantage affiliate and employed providers to ensure stable and geographically disperse networks for the Kelsey-Seybold commercial and Medicare Advantage health plans and KS Plan Administrators' health plan products.
Primary Responsibilities:

• Responsibilities include providing educational instruction and support to physicians and their staff
• Be the main point of contact for the respective providers and will routinely visit physician's offices for issues concerning the achievement of quality outcomes, provider satisfaction, medical cost targets, network growth and/or efficiency targets
• Responsibility for education of the physicians and office staff on health plan products and benefits, policy and procedure for multiple managed care plans, assistance with claims payments and other duties as assigned
• Travel requirements - local and extensive

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:

• 5+ years of professional level experience in clinic or healthcare operations
• CPT and ICD-10 coding and prior experience with reimbursement methodologies
• Proven knowledge of claims processing, clinic operations, managed care plan benefits and utilization management policies and procedures
• Network development and/or provider relations experience
• Microsoft Word and Excel experience
• Proven analytical and problem-solving skills; ability to communicate effectively in writing and verbally
• Proven public speaking and presentation skills
• Valid Texas Driver's License and ability to travel
• Own or lease a working vehicle and be able to travel daily within the Greater Houston area

Preferred Qualifications:

• 5+ years of experience in applicable healthcare administrative operations
• 3+ years of experience in Medicare/Commercial products
• Ability to interpret provider contracts and regulatory contracts
• Experience with the development of provider relations and/or clinical networks
• Ability to work in a fast-paced environment; demonstrated ability to perform multiple concurrent tasks with minimal supervision and meet deadlines
• Proficiency with Excel and/or PowerPoint
• Excellent communication and relationship development skills with multiple different types of stakeholders. Outcomes driven
• Capable of managing a variety of complex issues while driving momentum of key projects

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 - $107,400 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.