[Hiring] Senior Provider Relations Advocate @UnitedHealth Group

Role Description

The Senior Provider Relations Advocate serves as a subject matter expert and strategic liaison responsible for managing complex provider relationships and resolving high-impact claims, payment, authorization, access, data, and operational issues. This role partners closely with providers, internal business partners, payer organizations, and leadership to drive timely resolution, strengthen provider relationships, and continuously improve the provider experience.

The successful candidate will demonstrate strong executive presence, sound judgment, and the ability to effectively navigate challenging or sensitive provider situations. This individual must be skilled at de-escalating concerns, communicating with confidence and credibility, and developing solutions in situations where established processes may not fully address the issue. Exceptional communication skills are essential, including the ability to present effectively to large audiences, facilitate difficult conversations, and develop and deliver provider education and training when needed.

Working with minimal supervision, the Senior Provider Relations Advocate independently researches, analyzes, and resolves complex and often ambiguous issues requiring cross-functional coordination. The role is expected to maintain ownership from initial identification through resolution, identify root causes, drive accountability across business areas, appropriately escalate barriers and risks, and recommend sustainable solutions that reduce operational friction and improve provider outcomes.

The ideal candidate will bring strong analytical, problem-solving, relationship-management, and influencing skills. Claims expertise is solidly preferred, as a significant component of the role involves researching and resolving escalated claims, payment, reimbursement, and related operational issues.

If you are located in Rhode Island, you will have the flexibility to work remotely as you take on some tough challenges.

Qualifications

• High school diploma or equivalent
• 5+ years of healthcare and/or managed care experience
• 3+ years of provider relations and/or provider network management experience
• Experience independently researching and resolving complex provider or operational issues
• Experience presenting information to groups and facilitating professional discussions
• Demonstrated experience managing challenging customer or provider interactions and effectively de-escalating concerns
• Proficiency with Microsoft Word, Excel, PowerPoint, Access, and related business applications
• Demonstrated problem-solving, analytical, and critical-thinking skills
• Proven excellent written and verbal communication skills, with the ability to tailor communication to providers, business partners, and leadership audiences
• Demonstrated ability to manage competing priorities and multiple complex issues in a fast-paced environment
• Demonstrated ability to influence outcomes through collaboration, credibility, and relationship building
• Demonstrated ability to exercise sound judgment and make decisions in complex or ambiguous situations
• Must reside in Rhode Island

Requirements

• Claims processing, claims operations, and/or complex claims-resolution experience
• Experience with provider reimbursement, payment integrity, claims adjudication, and/or prior authorization workflows
• Experience managing complex or high-profile provider escalations
• Experience working with physicians, hospitals, health systems, and senior healthcare leaders
• Experience conducting root cause analysis and implementing sustainable process improvements
• Experience working across operational, clinical, financial, contracting, and technology teams to resolve complex issues
• Experience developing or delivering provider education, presentations, or training
• Knowledge of healthcare provider operations and managed care environments

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (subject to eligibility requirements)