Director, Provider Service ~ Nashville, TN Job Opening at UnitedHealth Group in Nashville, TN

What makes your Provider Relations career greater with UnitedHealth Group? Growth opportunities among the variety of product lines and making an impact on the healthcare system ensures it will always be challenging and exciting. The Director of Provider Service is responsible for the full range of provider relations and service interactions within UnitedHealth Group, including working on end-to-end provider claim and call quality, ease of use of physician portal and future service enhancements, and training and development of external provider education programs. Directors of Provider Service design and implement programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Responsibilities also include directing and implementing strategies relating to the development and management of a provider network, identifying gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs, and may also be involved in identifying and remediating operational short-falls and researching and remediating claims.

In this role you will be expected to:

• Own an end to end process.
• Develop functional, market level, and/or site strategy, plans, production and/or organizational priorities.
• Identify and resolve technical, operational and organizational problems outside own team.
• Product, service or process decisions are most likely to impact entire functions and/or customer accounts (internal or external).
• Ideal candidate will have significant Leadership experience at the Market Level.

• Undergraduate degree is strongly preferred. Strong network development and management experience may be considered in lieu of a Bachelor's degree.
• 5+ years experience in the health care industry.
• 5+ years experience in provider relations and/or network management related role handling complex network providers with accountability for business results.
• Minimum of 3+ years of supervisory experience.
• Advanced level of knowledge of claims/systems processes, contracting and reimbursement methodologies.
• Experience with Medicare and Medicaid regulations is strongly preferred.
• Exceptional presentation, written and verbal communication skills.
• Ability to work independently and remain on task.
• Good organization and planning skills.
• Ability to prioritize and meet deadlines from multi-staff members within the department.
• Expert level of proficiency with MS Word, Excel, and Access.
• Ability to work in a highly matrixed environment.

UnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus:

UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, affordable benefits services.

UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.

UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.

Together, we're removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being.

Come grow and thrive in our culture of innovation and ideas. Because there is no opportunity greater than the quest to help people live healthier lives.