HCBS Provider Advocate - Remote in Kalamazoo, MI

UnitedHealthcare; Kalamazoo (MI); Remote; USD 59,000 - 117,000; Full time

Job summary

A leading healthcare company seeks an HCBS Provider Advocate to manage provider claims and enhance relationships within Michigan. The role involves training providers, troubleshooting concerns, and ensuring customer satisfaction while working remotely with travel requirements. Join a mission-driven team dedicated to improving healthcare access and quality.

Benefits

Comprehensive health packages

Incentive programs

Stock purchase options

401k plan

Qualifications

• At least 2 years of experience in healthcare or claims management.
• Experience managing multiple projects and priorities.

Responsibilities

• Training and ongoing education of providers on policies and procedures.
• Troubleshooting provider concerns and ensuring timely resolution.
• Traveling to provider offices to build relationships (up to 75%).

Skills

Healthcare

Claims Management

Communication

Analytical

Education

High School Diploma or GED

Tools

MS Office

Job description

HCBS Provider Advocate - Remote in Kalamazoo, MI

At UnitedHealthcare, we’re dedicated to simplifying the healthcare experience, creating healthier communities, and removing barriers to quality care. Your work will impact the lives of millions, helping to build a more responsive, affordable, and equitable healthcare system. Join us to start Caring. Connecting. Growing together.

The HCBS Provider Advocate for UnitedHealthcare Community Plan of Michigan is responsible for managing end-to-end HCBS and In Lieu of Services (ILOS) provider claims, enhancing the usability of the UnitedHealthcare Self Help tool, and developing external provider education programs. The role involves designing and implementing programs to foster positive relationships between the health plan and HCBS and ILOS providers.

Additional responsibilities include developing and managing the HCBS provider network, identifying service gaps, supporting contracting and network development, and addressing operational issues related to claims processing.

The primary goals are to ensure customer satisfaction, assist providers in utilizing our services effectively, serve as the provider advocate, and execute responsive issue resolution and communication strategies.

This position offers the flexibility to work remotely within Michigan, with up to 75% travel to provider offices within Kalamazoo and surrounding areas.

Primary Responsibilities

• Training and ongoing education of providers on policies and procedures
• Participating in regional/association meetings with Managed Care entities and providers
• Troubleshooting provider concerns and ensuring timely resolution
• Traveling to provider offices to build relationships (up to 75%)
• Presenting training sessions on new and existing requirements
• Documenting outreach activities
• Educating providers on claims submission, coding updates, etc.
• Analyzing call center data to identify trends and improve provider satisfaction
• Performing other duties as assigned to support the Michigan UHCCP

Required Qualifications

• High School Diploma or GED
• At least 2 years of experience in healthcare or claims management
• Experience managing multiple projects and priorities
• Tracking and reporting on metrics for at least 1 year
• Proficiency with MS Office (Excel, Word, PowerPoint)
• Residing in Michigan with reliable transportation for travel

Preferred Qualifications

• Experience in Provider Relations and knowledge of Michigan Medicaid
• Understanding of Long-Term Services and Supports providers
• Strong analytical, communication, and presentation skills
• Ability to manage multiple high-priority projects and meet deadlines

The salary range is $59,500 to $116,600 annually, based on full-time employment and various factors. Benefits include comprehensive health packages, incentive programs, stock purchase options, and a 401k plan. UnitedHealth Group is committed to diversity, equity, and inclusion, and is an Equal Employment Opportunity employer. We also require a drug test prior to employment.