New Mexico Medicaid Dental Provider Advocate

Full Time
Albuquerque, NM 87106 (University Hts area)
Posted 12 days ago
Job description

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

The Dental Provider Advocate is responsible for the full range of Medicaid provider relations service to include interactions with providers, clients, and internal stakeholders. Candidate will be responsible for receiving escalated issues and resolving complex problems, including working on end-to-end provider claim issues, ease of use of provider portal, future service enhancements, and training & development of external provider education programs. The Provider Advocate develops the provider dental network yielding a geographically competitive, broad access, stable network that achieves objectives and produces an affordable and predictable product for customers and business partners. The Provider Advocate will initially evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining solid business relationships and ensuring the network composition includes an appropriate distribution of provider specialties.

If you are located in New Mexico, you will have the flexibility to telecommute* as you take on some tough challenges. Preference for candidate in Albuquerque or Santa Fe commuter areas.

Primary Responsibilities:

  • This is a telecommuter role and will need to be located within a commutable distance of the metro Albuquerque, NM
  • Act as the liaison between the provider, client, and internal stakeholders
  • Use pertinent data and facts to identify and solve a range of problems within area of expertise
  • Be able to be empathic and have a solid emotional intelligence while working with clients, stakeholders, and partnerships
  • Prioritize, organize, and manage workload autonomously to meet goals and deadlines
  • Handle high level escalations
  • Provide explanations and information to others on topics within area of expertise
  • Ability to facilitate virtual or in-person trainings with providers
  • Ensure provider database and documentation is accurate, complete, and submitted promptly

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:

  • 2+ years of professional experience in healthcare, dental-related industry, or sales
  • Ability to be successful at prospecting new and existing leads of potential new providers
  • Intermediate level of proficiency with MS Excel, Outlook, and Word
  • Willing and able to travel up to 25% of the time within territory
  • Located in New Mexico
  • Lives within a commutable distance of Albuquerque or Santa Fe, New Mexico
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

  • Undergraduate degree
  • Experience within healthcare negotiating contracts and/or provider relations
  • Experience in a Sales/Call environment
  • Work experience administering Medicaid plans
  • Salesforce experience
  • Facets experience
  • Knowledge of Medicaid, PPO, and Medicare Advantage reimbursement methodologies
  • Knowledge of claims processing systems and guidelines
  • Dental industry knowledge
  • MS PowerPoint
  • Exceptional sales presentation skills in a high-pressure environment
  • Solid written and oral communication and ability to interact with Sr. Leadership
  • Issue resolution and problem-solving skills

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)

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

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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

Intrested in this job?