Provider Relations Advocate — Remote SNF & LTC Partnerships

Dovetail Health Inc.; Boston (MA); Remote; USD 60,000 - 107,000; Full time

Job summary

Optum Home & Community Care, part of the Optum family, is expanding our Senior Community Care team in Massachusetts. As a Provider Relations Advocate, you will strengthen partnerships with skilled nursing facilities and long-term care providers, helping navigate Medicare and MassHealth processes, billing, and authorization.

The role emphasizes collaboration with facility leadership, billing teams, and clinical staff to resolve issues, educate providers, and improve the overall provider

Qualifications

• 1+ years in SNF or LTC settings.
• 1+ years in provider operations, provider relations, billing, reimbursement, admissions, utilization review, authorization, care coordination, or related functions.
• Proven working knowledge of Massachusetts SCO and MassHealth (Medicare/Medicaid) coordination.
• Experience collaborating with facility leadership, business office staff, billing teams, clinical staff, and external stakeholders.
• Intermediate proficiency with Microsoft Office.
• Driver's license and access to reliable transportation.

Responsibilities

• Serve as a trusted resource to SNFs and long-term care providers, helping navigate claims, billing, authorization, and operational processes.
• Experience with SCO and MassHealth policies and regulations in MA.
• Support provider relations, billing, reimbursement, admissions, utilization review, authorization, and care coordination processes.
• Build solid provider relationships while supporting issue resolution and provider education initiatives.

Skills

Provider relations

Billing

Reimbursement

Care coordination

Utilization review

Authorization

Microsoft Office

Driver's license

Education

High school diploma/GED or equivalent experience

Job description

Optum Home & Community Care, part of the Optum family, is expanding our Senior Community Care team in Massachusetts. As a Provider Relations Advocate, you will strengthen partnerships with skilled nursing facilities and long-term care providers, helping navigate Medicare and MassHealth processes, billing, and authorization.

The role emphasizes collaboration with facility leadership, billing teams, and clinical staff to resolve issues, educate providers, and improve the overall provider