Senior Provider Relations Representative

Responsibilities

• Serve as the primary liaison between clients and the MSO for Managed Care Administrative Services, providing clear explanations of all service phases to IPA groups.
• Coordinate and conduct meetings within the assigned territory, including preparing agendas, handouts, and maintaining official minutes.
• Resolve provider issues by acting as a resource for internal referrals and collaborating with Claims and Medical Management departments.
• Manage the interface between providers, the MSO, and health plans through regular office visits, education, and training.
• Recruit providers in designated geographic areas and assist in negotiating contracts within specified guidelines.
• Develop and distribute provider manuals, directories, and other essential communications.
• Monitor internet portal usage, providing troubleshooting and training to vendors and users.

Requirements

• 5+ years of experience in managed care.
• Proven experience in managed care operations.
• Experience training individuals in small or large groups with strong presentation skills.
• Experience organizing meetings and taking official minutes.
• Knowledge of CPT and ICD-9 codes.
• Ability to interpret contract language, rates, and coverage definitions.
• Proficiency with Microsoft Office and various managed care programs.
• Valid California Driver's License and reliable transportation.

Benefits

• Comprehensive health plans and coverage for you and your loved ones.
• Financial benefits including retirement planning and 401k contributions.
• Incentive and recognition programs.
• Equity stock purchase options.
• Resources for emotional well-being and stress management.

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 addressing health disparities through innovation and excellence in managed care.