Remote Provider Relations Advocate for Health Plans

Optum; Philadelphia (Philadelphia County); Remote; USD 60,000 - 107,000; Full time

Benefits offered by this job

Comprehensive benefits

Incentive programs

401k contribution

Job summary

Optum is seeking a Provider Relations Advocate—Remote within the Philadelphia Metro Area—to strengthen provider partnerships and resolve issues across claims, enrollment, and credentialing. The role focuses on payer operations experience, cross-functional collaboration, and delivering improved provider experiences while supporting health plan administration.

The position offers remote flexibility in the Philadelphia area, with a salary range of $60,200 to $107,400 depending on experience, plus

Qualifications

• 3+ years of experience working for a health insurance carrier, managed care organization, or payer operations team.
• 1+ years of provider relations, provider services, network management, or provider network experience.
• Experience resolving provider issues involving claims adjudication, reimbursement, eligibility, prior authorization, credentialing, or enrollment processes.
• Experience collaborating with cross-functional operational teams including claims, network, provider services, and customer operations.

Responsibilities

• Serve as a liaison between the health plan and provider community, leveraging expertise in managed care operations, provider servicing, claims resolution, reimbursement processes, and network management.
• Build relationships with providers and internal stakeholders to improve processes and resolve operational challenges.
• Assist in provider network management and provider data accuracy to enhance overall provider satisfaction.

Skills

Provider relations

Customer service

Claims knowledge

Cross-functional collaboration

Microsoft Office

Education

High school diploma or equivalent

Job description

Optum is seeking a Provider Relations Advocate—Remote within the Philadelphia Metro Area—to strengthen provider partnerships and resolve issues across claims, enrollment, and credentialing. The role focuses on payer operations experience, cross-functional collaboration, and delivering improved provider experiences while supporting health plan administration.

The position offers remote flexibility in the Philadelphia area, with a salary range of $60,200 to $107,400 depending on experience, plus