Provider Relations Representative

Responsibilities

• Serve as the primary liaison between clients and the MSO for Managed Care Administrative Services, resolving provider issues and managing health plan interfaces.
• Coordinate and co-chair client board and regional meetings, including preparing agendas, handouts, and official meeting minutes.
• Act as a resource for internal referrals regarding provider issues and support the Client Services Department in resolving complex inquiries.
• Manage the interface between providers, the MSO, and health plans by maintaining regular contact and conducting office visits for education and training.
• Assist in recruiting providers within designated geographic areas and negotiating contracts within specified guidelines.
• Develop and facilitate the distribution of provider manuals, directories, and other related communications.
• Manage internet portal user set-up, training, and troubleshooting for vendors.

Requirements

• 2+ years of experience in managed care operations and/or a clinical/office setting.
• Proven experience in training individuals on managed care policies and procedures with strong presentation skills.
• Experience organizing professional meetings and taking accurate minutes.
• Working knowledge of CPT and ICD-9 codes.
• Exposure to contract language, rates, and coverage definitions.
• Proficiency with Microsoft Office and various managed care programs.
• Valid California Driver's License and reliable transportation.
• Ability to work independently and communicate professionally with diverse stakeholders.

Benefits

• Comprehensive benefits package including health plans and wellness support.
• Financial security through 401k contributions and equity stock purchase programs.
• Incentive and recognition programs.
• Access to emotional and physical wellness resources.

About the Company

Optum is part of UnitedHealth Group, dedicated to helping people live healthier lives and making the health system work better for everyone. We are committed to delivering equitable care and building a culture of belonging through innovation and compassion.