Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual’s physical, mental and social needs – helping patients access and navigate care anytime and anywhere.

As a team member of our naviHealth product, we help change the way health care is delivered from hospital to home supporting patients transitioning across care settings. This life-changing work helps give older adults more days at home.

We’re connecting care to create a seamless health journey for patients across care settings. 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.

Need to be located in/close to the following counties: Albany, Broome, Clinton, Columbia, Dutchess, Fulton, Greene, Orange, Rockland, Saratoga, Schenectady, Steuben, Sullivan, Tioga, Ulster, Warren, Washington, Westchester.

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 levels
• 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:

• 2+ years of experience in a provider-facing or account management role
• Proficiency with Microsoft Office applications
• Proven ability to build and foster relationships inside and outside the organization
• Proven ability to independently plan, organize and prioritize work
  

Preferred Qualifications:

• Bachelor’s degree
• Data analytics and reporting experience
• Experience in Acute and Post-Acute Care Continuum
• Experience in managed care, health plan operations, provider contracting, customer service, or provider relations
• Proven effective negotiation and influencing skills
• Proven solid brand promotion and management skills
  

Work Conditions and Physical Requirements

• Ability to establish a home office workspace
• Ability to manipulate laptop computer (or similar hardware) between office and site settings
• Ability to view screen and enter data into a laptop computer (or similar hardware) within a standard period
• Ability to communicate with clients and team members including use of cellular phone or comparable communication device
• Ability to remain stationary for an extended period (1 - 2 hours)
• Travel requirements - Up to 35% travel
  

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.

New York Residents Only: The salary range for New York residents is $67,800 to $133,100. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.

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.