University of Utah Health Care

  • Health Plans Provider Relations Consultant

    Requisition Number
    31078
    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
  • 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.

     

    The territory for this position will include professional providers including physicians, practitioners, physical therapy providers, chiropractic, behavioral health providers, audiologists, podiatrists, optometrists, and dentists in Salt Lake County and the state of Nevada.  It also includes the following: 

    • Shriners Hospital
    • Dialysis Centers
    • Interpreting Agencies
    • Independent hospitals in geographic territory
    • Ambulatory Surgical Centers in geographic territory
    • Steward Hospitals
    • Physician Group of Utah (PGU)
    • Pathology Labs

    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

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