Field-Based Provider Relations Advocate

UnitedHealth Group; Fairfax (VA); On-site; USD 73,000 - 130,000; Full time

Job summary

UnitedHealth Group in Fairfax, VA is seeking a Healthcare Advocate to coordinate provider relations and support documentation and coding improvements for Medicare Advantage members. Travel about 75% to engage physicians, clinics, and hospitals, while aligning to CMS standards and risk adjustment initiatives.

You will lead coding training, data-driven provider outreach, and collaboration with multidisciplinary teams to implement prospective programs under leadership guidance, delivering

Qualifications

• 3+ years of healthcare experience with strong knowledge of medical terminology and clinical issues.
• 1+ years of experience with EMR systems.
• Knowledge of ICD-10, HEDIS, and Stars programs.
• Ability to identify automation opportunities and leverage AI to improve productivity and quality.
• Experience using MS Office (Excel, Word, PowerPoint) to manipulate data and create presentations.
• Ability to communicate, engage and develop relationships across diverse audiences and teams.
• Must travel approx. 75% in the Fairfax VA region and have reliable transportation.
• Must have valid Driver's License and current auto insurance.

Responsibilities

• Act as trusted advisor to providers and medical groups for accurate documentation and coding.
• Travel across the assigned territory to engage providers with Optum tools and programs.
• Support participation and deployment of Prospective Programs to achieve business goals.
• Use data analysis to identify providers who need coding and quality training resources.
• Build long-term consultative relationships with physicians, IPAs and hospitals.
• Develop plans to improve RAF performance, coding specificity, and gap closure.
• Manage end-to-end Risk Adjustment and Quality programs including in-office assessments.
• Consult on documentation gaps and provide feedback to improve CMS compliance.
• Offer guidance on EMR/EHR issues affecting documentation accuracy.
• Collaborate with multidisciplinary teams to implement prospective programs.
• Educate providers on Medicare quality programs and CMS-HCC methodology.
• Support documentation alignment with ICD-10 and CPT II guidelines and standards.
• Deliver ICD-10 HCC training and develop tools for staff.
• Provide actionable solutions to improve documentation and coding accuracy.
• Partner with physicians, coders and staff on risk adjustment and quality education.

Skills

Healthcare experience

ICD-10, HEDIS and Stars knowledge

AI / automation awareness

Communication across diverse audiences

Willing to travel 75%+

Driver's license & auto insurance

Education

Certified Professional Coder (CPC/CPC-A)

CRC certification

Nursing background (LPN, RN, NP)

Tools

EMR systems

MS Office (Excel, Word, PowerPoint)

MS Excel (advanced)

Job description

UnitedHealth Group in Fairfax, VA is seeking a Healthcare Advocate to coordinate provider relations and support documentation and coding improvements for Medicare Advantage members. Travel about 75% to engage physicians, clinics, and hospitals, while aligning to CMS standards and risk adjustment initiatives.

You will lead coding training, data-driven provider outreach, and collaboration with multidisciplinary teams to implement prospective programs under leadership guidance, delivering