Healthcare Advocate - Field-Based Position

UnitedHealth Group; Honolulu (HI); On-site; USD 73,000 - 130,000; Full time

Benefits offered by this job

Comprehensive benefits

Incentive programs

401(k) plan

Job summary

UnitedHealth Group in Hawaii seeks a Healthcare Advocate for field-based work across Medicare Advantage, Medicaid, and ACA programs. You will partner with physicians and hospitals to improve documentation, coding accuracy, and RAF performance while delivering training and data-driven strategies.

The role requires significant travel (approx. 85%), strong healthcare knowledge, and proficiency with EMR systems.

Qualifications

• 3+ years of healthcare experience with medical terminology.
• 2+ years of EMR experience.
• Experience in physician offices, clinics, or hospitals.
• Knowledge of ICD-10, Risk Adjustment, HEDIS/Stars programs.
• Proficiency in MS Office with data manipulation.
• Willingness to travel ~85% and reside in Honolulu.

Responsibilities

• Act as a trusted advisor to providers to improve documentation and coding.
• Travel ~80–85% to engage providers in Optum tools and programs.
• Identify gaps and deploy coding, documentation, and quality training resources.
• Develop provider-specific plans to improve RAF performance and gap closure.
• Educate providers on Medicare quality programs and CMS-HCC methodology.

Skills

Healthcare terminology

EMR systems

Data analysis

MS Office

Education

CPC/CPC-A certification

CRC certification

Tools

MS Office

Job description

Improve the lives of others while Caring. Connecting. Growing together.

Job Description - Healthcare Advocate - Field-Based Position (2396298)

Healthcare Advocate - Field-Based Position - 2396298

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

The Healthcare Advocate serves as a strategic partner to physicians, medical groups, IPAs, and hospitals, supporting accurate documentation and coding practices to ensure a complete and accurate health picture of members across government and regulated lines of business, including Medicare Advantage, Medicaid, and ACA. This role focuses on improving quality of care, closing gaps in care, and driving performance in Risk Adjustment and Quality programs through education, collaboration, and data-driven strategies.

This is a field-based position covering travel territory based in Honolulu, HI.

Primary Responsibilities:

• Act as a trusted advisor and strategic partner to providers and medical groups, assisting in accurate documentation and coding to reflect members’ true health status
• Travel independently across the assigned territory (approximately 80% field-based, with occasional overnight travel) to engage providers in Optum tools and programs that enhance quality of care for Medicare Advantage members
• Responsible for gaining participation and deployment of Prospective Programs achieving business goals and metrics
• Utilize data analysis to identify and target providers who would benefit from coding, documentation, and quality training resources
• Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs and Hospitals
• Develop and implement comprehensive, provider-specific plans to improve RAF performance, coding specificity, and gap closure
• Manage end-to-end Risk Adjustment and Quality programs, including In-Office Assessment initiatives
• Consult with provider groups on documentation and coding gaps; provide actionable feedback to improve compliance with CMS standards
• Offer guidance on EMR/EHR system issues impacting documentation and coding accuracy.
• Collaborate with multidisciplinary teams to implement prospective programs as directed by leadership
• Educate providers on Medicare quality programs and CMS-HCC Risk Adjustment methodology, emphasizing the importance of accurate chart documentation for proper reimbursement
• Support providers in ensuring documentation aligns with ICD-10 and CPT II coding guidelines and national standards
• Deliver ICD-10 HCC coding training and develop tools for providers and office staff
• Provide measurable, actionable solutions to improve documentation and coding accuracy
• Partner with physicians, coders, and facility staff on Risk Adjustment and Quality education efforts
• Assist in chart collection and analysis as needed
• Demonstrated communication skills with ability to engage multiple stakeholders and collaborate across teams
• Self-driven, goal-oriented, and able to work independently while prioritizing tasks and meeting deadlines

You’llbe 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 asprovidedevelopment for other roles you may be interested in.

Required Qualifications:

• 3+ years of healthcare experience with solid knowledge of medical terminology and clinical issues
• 2+ years of experience with EMR systems
• Experience in a physician office, clinic, hospital, or similar medical setting
• Demonstrated knowledge of ICD-10, Risk Adjustment, HEDIS/Stars programs, and experience supporting gap closure initiatives to improve quality and coding outcomes.
• Demonstrated proficiency in MS Office (Excel, Word, PowerPoint) with ability to manipulate data, create documents, and deliver presentations
• Demonstrated ability to identify automation opportunities and leverage AI to improve productivity and quality
• Reside in the Honolulu, HI area to perform daily field travel requirements
• Able/willing to travel approximately 85% of the time, this is a field-based position that required daily local state travel
• Proof of a valid Driver’s License, reliable transportation, and current auto insurance to perform daily local state travel

Preferred Qualifications:

• Certified Professional Coder (CPC/CPC-A) or equivalent certification
• CRC certification

2+ years of clinic/hospital or managed care experience

• Experience in provider network management, physician contracting, healthcare consulting, or Medicare Advantage sales
• Territory management experience
• Demonstrated knowledge of billing claims submission, and coding software
• Demonstrated advanced proficiency in MS Excel (pivot tables, advanced functions)

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

UnitedHealth Group is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or accommodation for any part of the application process, please call 1-866-566-8715 to be connected to Recruitment Services. Recruitment Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through Friday.

UnitedHealth Group is a registered service mark of UnitedHealth Group, Inc. The UnitedHealth Group name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the UnitedHealth Group, Inc.

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.