Provider Relations Advocate

Optum; McAllen (TX); On-site; USD 60,000 - 107,000; Full time

Job summary

UnitedHealth Group in McAllen, TX is seeking a Provider Relations Advocate to support provider networks, claims processing, and provider education programs. This full-time role requires 4+ years in health care/managed care and 2+ years in provider relations, with 1+ year in claims processing and Medicare/Medicaid regulation knowledge.

The position involves travel 50–75% within the market and requires MS Office proficiency.

Qualifications

• Minimum high school diploma or GED required.
• 4+ years in health care/managed care experience.
• 2+ years in provider relations/ provider network.
• 1+ year in claims processing and issue resolution.
• 1+ year experience with Medicare and Medicaid regulations; ability to travel 50–75%.
• Proficient in MS Office.

Responsibilities

• Assist in end-to-end provider claims and help enhance call quality.
• Support ease of use of physician portal and future service enhancements.
• Contribute to design and implementation of programs to strengthen relationships between health plan, providers and practice managers.
• Support development and management of provider networks.
• Help train external providers through education programs.
• Identify gaps in network composition to assist contracting and development teams.
• Travel as needed 50-75% within market.

Skills

Provider relations

Health care experience

Claims processing

Education

High School Diploma/GED

Bachelor’s degree (preferred)

Tools

MS Office

Job description

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

Job Description - Provider Relations Advocate (2394087)

Provider Relations Advocate - 2394087

Explore opportunities with WellMed,part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will be part of a team who shares your passion for helping people achieve improved health outcomes. Explore rewarding opportunities for physicians, clinical staff and non-patient-facing roles. Join us and discover the meaning behindCaring. Connecting. Growing together.

Hours: Monday-Friday 8am-5pm

Primary Responsibilities:

• Assist in end-to-end provider claims and help enhance call quality
• Assist in efforts to enhance ease of use of physician portal and future services enhancements
• Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers
• Support development and management of provider networks
• Help implement training and development of external providers through education programs
• Identify gaps in network composition and services to assist network contracting and development teams
• Ability to travel as needed 50 - 75% within market

What are the reasons to consider working for UnitedHealth Group? Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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
• 4+ years of health care/managed care experience
• 2+ years of provider relations and/or provider network experience
• 1+ years of experience in claims processing and issue resolution
• 1+ years of experience with Medicare and Medicaid regulations Ability to travel as needed 50 - 75%
• Intermediate level of proficiency with MS Office

Preferred Qualifications:

• Access to reliable transportation and valid US driver’s license
• Bachelor’s degree in related field

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 $60,200 to $107,400 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 make the health system work better for everyone. We believe 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 experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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.

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.