Provider Relations Advocate - SNF/LTC (Remote)

Optum; Boston (MA); Remote; USD 60,000 - 107,000; Full time

Benefits offered by this job

Comprehensive benefits

Equity stock purchase plan

401k contribution

Job summary

Optum is hiring a Provider Relations Advocate in Massachusetts to strengthen partnerships with skilled nursing facilities and long-term care providers. The role emphasizes navigating claims, billing, authorization processes, and MassHealth policies to improve provider experience.

Ideal candidates have 1+ years in SNF/LTC or related provider operations, with solid MS Office skills and a valid driver's license. Remote work options available for MA residents.

Qualifications

• High school diploma or GED required; equivalent experience may suffice.
• 1+ years in SNF/LTC/post-acute care setting or provider organization serving senior populations.
• 1+ years supporting provider operations, provider relations, billing, reimbursement, admissions, utilization review, or related functions.
• Proven knowledge of Massachusetts SCO and coordination of Medicare and MassHealth benefits.

Responsibilities

• Serve as a trusted resource to skilled nursing facilities and long-term care providers to navigate claims, billing, authorization, and operational processes.
• Experience with SNF/LTC environment and understanding of MassHealth/SCO policies and regulations.
• Experience with facility billing, prior authorization workflows, claims management, and reimbursement processes; knowledge of nursing facility regulations is a plus.
• Build provider relationships and support issue resolution and provider education initiatives.

Skills

Microsoft Office

Driver's License

Education

High school diploma/GED or equivalent experience

Job description

Optum is hiring a Provider Relations Advocate in Massachusetts to strengthen partnerships with skilled nursing facilities and long-term care providers. The role emphasizes navigating claims, billing, authorization processes, and MassHealth policies to improve provider experience.

Ideal candidates have 1+ years in SNF/LTC or related provider operations, with solid MS Office skills and a valid driver's license. Remote work options available for MA residents.