TN Operations Provider Experience Manager - Remote

Job title: TN Operations Provider Experience Manager - Remote in Eden Prairie, MN at UnitedHealth Group
Company: UnitedHealth Group
Job description: Optum 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.As a Provider Experience Manager within Transparent Network (TN) Operations you will drive the client’s experience with our innovative solutions, optimize their value and generating revenue. Your responsibilities will include onboarding of new clients, monitoring client performance, and manage ongoing client relationships with TN solutions to ensure value is optimized! You will collaborate with cross-functional teams to drive the optimal value for our clients. We’re looking for that unique experienced individual with a unique combination of clinical, coding and revenue cycle expertise to join and contribute to our team!You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:

• Implementation Support: Observe/participate in implementations to proactively identify potential impacts to performance
• Provider Onboarding: Onboard new clients to our new solutions to ensure their adoption and engagement with the solution to driver value. Conduct working and education sessions with providers as needed. Drive client value using a consultative business approach with provider clients
• Performance Tracking: Conduct ongoing monitoring of clients against key metrics to ensure adoption of new solutions. Monitor client performance to ensure optimal value and escalate performance concerns to leadership and other stakeholders as needed
• New Edit Opportunities: Routinely analyze data to proactively identify potential new avenues to enhance value such as New Edit Opportunities and collaborate with product and development to prioritize and move those ideas forward
• Report Distribution: Run reporting and analyze client edit data to identify trends, generate actionable insights to improve client outcomes. Distribute to key stakeholders based on established cadence/rhythm
• Denial Analytics: Routinely analyze denial data to proactively identify trends and patterns that may indicate new opportunities to explore that may drive value. Use advanced Microsoft Excel , PowerPoint and Visio to analyze data/workflow to identify performance trends and patterns and potential root causes. Communicate findings and outputs to stakeholders in a meaningful way
• Client Relationships: listen, understand, and articulate client needs. Once live, strengthen client relationships and PCG usage by ongoing assessments, consistent meetings and ongoing collaboration
• Client Feedback: Obtain client feedback via calls and customer satisfaction surveys and other tools
• Value Management: Monitor and track client value to optimize benefit. Report performance results to clients via QBRs and other avenues.
• Develop and implement repeatable and scalable provider onboarding and other processes to streamline, improve scalability and accelerate product adoption
• Client Meetings: Attend client meetings to gather requirements, understand workflow
• Problem Resolution: Assist in identifying and resolving technical and operational production problems
• Cross-Functional Collaboration: Work with contacts across technology, implementation, operations and product teams to vet potential provider clients. This includes analyzing client data, presenting findings to Account Executives and Client Managers, presenting PCG to vetted provider clients

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:

• 10+ years of experience related to business analysis, healthcare operations, process improvement, or project management
• 10+ years of experience working directly with large, complex, high volume data sets, data systems, and integrated systems
• 10+ years of healthcare experience working with clients (payers and/or providers) identifying value driving opportunities
• Clinical experience preferably as a nurse (RN preferred)
• Clinical and ICD-10 coding expertise
• Deep experience working in a provider environment and organizations and with a variety of EMRs and Health Information Systems (HIS) to understand their workflow, technology and potential operational/business needs and challenges
• Experience in “diagnosing” client needs and recommending solutions that have measurable impact
• Proven professional verbal and communication skills, effective presentation skills
• Proven excellent listening & collaboration skills
• Ability to be highly self-motivated and self-directed individual with solid problem-solving skills
• Proven ability to operate and effectively navigate in a highly complex, matrix environment
• Proven solid relationship and interpersonal skills
• Ability to be a self-driven contributor to the Partner Enablement Team
• Collaborates with team to identify new opportunities
• Proficient with the Microsoft Office Suite to include Word, Excel, PowerPoint

Preferred Qualifications:

• Coding/Clinical Documentation Improvement Certification
• 10+ years of experience working with healthcare, revenue cycle and/or claims data
• Proven end to end/deep knowledge into RCM (Revenue Cycle Management)
• Proven deep knowledge in denial management
• Deep experience with ICD-10 coding and/or related clinical documentation, certifications
• Ability to demonstrate and apply understanding of health care industry trends and their drivers
• Ability to be self-motivated and driven, ability to work independently and with solid follow through
• Experience working in an ambiguous and dynamic environment and comfortable collaborating with multidisciplinary design teams in a non-hierarchical organization

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.The salary range for this role is $89,800 to $176,700 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.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.UnitedHealth Group 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.UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Expected salary: $89800 - 176700 per year
Location: Eden Prairie, MN
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