Remote HCBS Provider Relations Advocate

UnitedHealthcare; Albuquerque (NM); On-site; USD 60,000 - 107,000; Full time

Benefits offered by this job

Comprehensive benefits

401k and equity stock options

Job summary

UnitedHealthcare is seeking a Provider Relations Advocate in Albuquerque, NM, with remote flexibility and up to ~25% travel within New Mexico. You will advocate for providers, resolve enrollment, billing and claims issues, and educate providers on HCBS programs.

The role requires 2+ years in health care, provider relations, and Medicare/Medicaid knowledge, with strong customer service skills. The position offers a comprehensive benefits package, incentive programs, equity stock purchase, and

Qualifications

• High School Diploma or GED required.
• 2+ years in health care or managed care.
• 2+ years in provider relations and/or provider network.
• 2+ years of Medicare/Medicaid regulations.
• Proficiency in claims processing and issue resolution.

Responsibilities

• Resolve escalated provider issues related to enrollment, billing, and claims, managing cases through resolution.
• Conduct ongoing provider education and training in virtual and in-person settings.
• Serve as SME for HCBS providers including ABCB, SDCB, EPSDT, and Home Health.
• Support enhancements to the provider portal and future service improvements.
• Conduct annual provider audits (virtual and onsite).
• Assist in designing and implementing programs strengthening collaboration between health plan and provider community.
• Support development and management of provider networks.
• Identify network gaps and assist contracting and network development teams.

Skills

Provider relations

Customer service

Claims processing

Medicare/Medicaid knowledge

Travel 25%

Communication

Education

High School Diploma/GED

Tools

EVV systems

Microsoft Office

Job description

UnitedHealthcare is seeking a Provider Relations Advocate in Albuquerque, NM, with remote flexibility and up to ~25% travel within New Mexico. You will advocate for providers, resolve enrollment, billing and claims issues, and educate providers on HCBS programs.

The role requires 2+ years in health care, provider relations, and Medicare/Medicaid knowledge, with strong customer service skills. The position offers a comprehensive benefits package, incentive programs, equity stock purchase, and