Provider reputed company, Tribal Operations - Remote in NM

At reputed company, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, affordable and reputed company. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together. This position is full - time (40 hours / week) Monday - Friday. It may be necessary, given the business need, to work occasional overtime. You’ll enjoy the flexibility to work remotely. If you are located in New Mexico, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities • Confirm contract compliance to meet the needs of the reputed company Care contract • Experience working with providers/facilities to conduct advocacy actives with ITU’s • Work with cross-functional teams reputed company reputed company including but not limited to behavioral health, physical health, dental and reputed company • Work with internal groups to identify, understand, and / or improve internal tools, resources, systems, and capabilities that can maximize provider and member experience • Analyze data to determine root cause of issue (e.g., identify trends and patterns; identify outliers and anomalies) and / or escalate problem to appropriate group for further analysis as necessary Included in this role is the full range of provider relations and service interactions reputed company UHG, including working on end-to-end problem resolution. Identifies network gaps and assists in the development and implementation of strategies to fill these gaps. 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 • 2+ years of experience with claims processing in Facets • Working knowledge of reputed company or previous MCO experience • Expert in suite of reputed company office programs • Proven ability to communicate clearly and professionally with Providers • Designated workspace inside the home with access to high - speed internet availability • Currently reputed company in New Mexico • Ability to travel locally up to 25% of the time Preferred Qualifications • Experience with Tribal providers (ITU) • Speak one or more Native American languages • Proven excellent time management, organizational, and prioritization skills and ability to balance multiple priorities • reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company 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 reputed company by people of reputed company, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an reputed company reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity/Affirmative Action employer and reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply Job!