University of Utah Health Health Plans Provider Relations Consultant in Murray, Utah

Overview

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, diversity, integrity, quality and trust that are integral to our mission. EO/AA

This position for use in Health Plans Departments only.

The Provider Relations Consultant positions serves as a liaison between UUHP and the provider community, developing and maintaining collaborative working relationships with their assigned providers. This position plays a pivotal role in influencing, educating and leading both internal and external business groups in order to optimize business results and ensure exceptional customer experiences.

This position is not responsible for providing care to patients.

This position will be assigned to the Idaho, Wyoming, and Nevada territory.

Responsibilities

  • Networks and builds professional relationships with key stakeholders both internal and external to UUHP.

  • Implements provider relations’ activities that support company goals, objectives and strategies.

  • Coordinates with multiple departments to ensure contract terms and provisions are effectively communicated and implemented.

  • Functions as a single point-of-contact for escalated billing and policy or service issues as needed by providers; develops and implements solutions that are beneficial to providers, UUHP customers, and the overall objectives of UUHP.

  • Educates providers about UUHP’s expanding portfolio of products, services and initiatives.

  • Serves as a resource and consultant to Customer Service and Care Management departments on provider issues.

  • Serves as a liaison between providers and UUHP, maintaining consistent communications with physicians and providers, including policy changes and updates.

  • Maintains current knowledge of appropriate contractual provisions and of government regulations related to the establishment and maintenance of contractual arrangements.

  • Represents UUHP Provider Relations and Contracting department at various internal and external meetings.

  • Independently manages relationships for the largest and most complex provider partnerships.

Knowledge / Skills / Abilities

  • Extensive knowledge of UUHP product lines and benefit structures.

  • Ability to travel extensively within a designated geographic area.

  • Knowledge of medical documentation, coding and billing standards for an array of provider types.

  • Ability to work in high-pressure circumstances and effectively manage conflict and ambiguity.

  • Strong oral and written communication skills to effectively communicate with a broad array of internal and external contacts.

  • Proven ability to build and maintain positive relationships with large and complex market-leading institutional and professional providers.

  • Knowledge and understanding of the provider community and principles of healthcare delivery systems.

  • Self-motivated with effective time management skills.

  • Strong knowledge of healthcare operations and billing principles.

  • Good analytical and problem solving abilities.

  • Proficient with word processing, spreadsheet, database, internet and e-mail applications.

  • Knowledge of and experience with Medicaid and Medicare insurance programs preferred.

  • Familiarity with appropriate local, state, and federal regulations.

  • Committed to transforming the way health care is delivered.

Qualifications

Qualifications

Required

  • Bachelor’s Degree in healthcare, business or related field.

  • Three years’ experience in the healthcare industry with specific focus in provider or payer relations, provider or payer contracting, customer service, or financial analysis.

  • Valid driver’s license.

Qualifications (Preferred)

Preferred

  • Medical claims experience.

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

  • This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.

Physical Requirements

Listening, Sitting, Speaking, Standing

Requisition Number 29522

Reg/Temp Regular

Employment Type Full-Time

Shift Day

Work Schedule 8:00 - 4:30

Location Name University of Utah Health Plans

Patient Care? No

City Murray

State UT

Department UIP CST 01H UUHP PROVIDER SRVC

Category Insurance / Health Plans

The University of Utah Health Care is an Affirmative Action/Equal Opportunity employer. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities. The University of Utah Health Care is committed to diversity in its workforce. Women and minorities are encouraged to apply.