Provider Service Representative

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Schedule: Monday to Friday, 7:00 AM-3:30 PM

Location: Hybrid - 1901 Solar Dr Ste 265, Oxnard, CA 93036

If you live near Oxnard, CA, you will enjoy the flexibility of a hybrid-remote role as you take on some tough challenges.

Primary Responsibilities:

• Provide direct support to network providers, staff and administrators related to HEDIS & IHA Quality Measures as well as RISK adjustment programs
• Responsible for training in network primary care provider including staff
• Training related to quality measure specifications and computation engine portal (COZEVA) for the purpose of managing and closing quality metrics
• In-Office/virtual trainings as required by client
• Attend health plan meetings related to quality and risk management
• Provide support and share tools available in area of opportunity
• Assist with health plan-based projects which may include mailing campaigns, training sessions and activities, member outreach (via phone or other methods), etc.
• Help implement training and development of external providers through education programs
• Identify gaps in network composition and services to assist network contracting and development teams

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:

• High School Diploma/GED (or higher)
• 2+ years of managed care or medical insurance experience
• 1+ years of experience in a claim, customer service or provider support role
• Beginner level of proficiency with oral communication skills including telephone etiquette
• Beginner level of proficiency with MS programs including Excel and Word
• Access to reliable transportation and valid US driver's license

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

The salary range for this role is $16.88 to $33.22 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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