Senior Provider Relations Representative - Korean Speaking - Optum : Job Details

Job Summary:

Join UnitedHealthcare to simplify the health care experience, create healthier communities, and remove barriers to quality care. Your work will impact millions, helping to build a more responsive, affordable, and equitable health care system.

Responsibilities:

• Assist with provider claims and enhance call quality.
• Identify and solve problems using data.
• Investigate non-standard requests.
• Design and implement programs to build positive relationships with providers.
• Implement training and development programs for external providers.
• Identify gaps in network composition and assist with network development.

Key Skills:

• Relationship building, flexibility, and reliability.
• Hands-on experience with issue resolution and contract maintenance.
• Engage providers in process improvements.
• Produce and distribute operational reports.
• Collaborate with other managers to foster teamwork.
• Implement strategies for provider network development.
• Resolve provider complaints to improve ratings and referrals.
• Collect charts for HEDIS/STAR measures and quality metrics.
• Manage relationships with key Asian medical groups.

Qualifications:

• 4+ years of health care/managed care experience.
• 2+ years of provider relations/network experience.
• Proficient in English/Korean.
• Proficiency with MS Word, Excel, PowerPoint, and Access.
• Intermediate proficiency in claims processing and issue resolution.
• Familiarity with Medicare and Medicaid regulations.