Provider Relations Advocate - North Riverside County, CA residency required

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. 

Optum’s Pacific West region is redefining health care with a focus on health equity, affordability, quality, and convenience. From California to Oregon and Washington, we are focused on helping more than 2.5 million patients live healthier lives and helping the health system work better for everyone. At Optum Pacific West, we care. We care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions.

As a Provider Relations Advocate at Optum, you will act as a direct interface between Optum and the affiliated physicians in Optum’s Independent Physician Association (IPA) network and support their operations and performance success.  This position provides continuous education, support, training and troubleshooting to physicians and their staff. 

The main office for this position will be in Ontario, CA; this position will require regular travel across North Riverside County to include Riverside, Norco, Moreno Valley, Jurupa Valley. 

Primary Responsibilities:

• Serve as single-point-of-contact to the physician network and is an accountable owner, responsive to physician needs. Knowledgeable about incentive programs, contract reimbursement, Optum’s internal processes and priorities, and other Optum initiatives, as applicable
• Monitors performance of assigned PCPs, identifies low performing PCPs and works with IPA leadership to develop action plan for specific metrics needing improvement. Works with office to effectuate action plans and monitors progress
• Intervenes and escalate issues as appropriate
• Maintains awareness of providers interested in further engaging with Optum on new business opportunities (contracts and business combinations), and on shifting market/competitive dynamics that would impact the IPA
• Works collaboratively with offices and Optum growth team to drive membership growth and retention
• Responds timely (within one business day) to provider issues, works with other groups/central departments to resolve issues and updates providers and office staff regularly through to resolution
• Build collaborative relationships with IPA physicians and their office staff

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 2 years of health care/managed care experience
• 2 years of provider relations and/or provider network experience
• Experience with Medicare and Medi-Cal regulations
• Understanding of healthcare systems billing
• Intermediate level of proficiency in claims processing and issue resolution
• Proficiency with Microsoft Office Suite
• Ability and willing to work a hybrid schedule (in the office 3 days per week when not in the field)
• Ability and willing to travel 50% within assigned territory 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy