Provider Relations Advocate - Remote in New Mexico

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This Provider Relations Advocate role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. We're building better, more effective provider networks every day. In this role, you'll use your strong customer service orientation and knowledge of insurance claims to serve as an advocate for providers in our networks. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 5 leader.

If you are located in New Mexico, you’ll enjoy the flexibility to work remotely as you take on some tough challenges. 

Primary Responsibilities:

• Resolves provider issues
• Act as SME for Home and Community Based Services providers within the health plan
• Assist in efforts to enhance ease of use of physician portal and future services enhancements
• Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers, provider administrative staff and practice managers
• Support development and management of provider networks
• Conduct in-person provider visits as needed
• Help implement training and development of external providers through education programs
• Identify gaps in network composition and services to support network contracting and development teams with insights for recruitment targets
• Build/sustain effective relationships with providers to maintain open lines of communication and ensure our awareness of their needs and the needs of our members
• Work with relevant internal stakeholders to identify obstacles and barriers identified by providers, and methods for removing them
• Involve leadership and / or escalate issues as necessary to implement provider /member solutions
• Train other Provider Advocates as needed

Are you ready for a challenge? You'll be part of a performance driven, fast paced organization that is serving multiple markets and you'll be charged with educating and building relationships with providers to evolve ongoing processes and programs.

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
• 1 years of experience with Medicare and Medicaid regulations
• Intermediate level of proficiency in claims processing and issue resolution
• Must live in the state of New Mexico
• Ability to travel up to 25% statewide

Preferred Qualifications:

• Proficiency with MS Word, Excel, PowerPoint

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

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. 

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.     

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.