[Hiring] Provider Relations Advocate @UnitedHealth Group

Role Description

As a Provider Relations Advocate with UnitedHealth Group, you'll play a critical role in strengthening provider partnerships and improving the health care experience for providers and members alike.

• Serve as a trusted resource and advocate for providers.
• Use customer service skills, managed care knowledge, and claims expertise to help resolve issues and improve the provider experience.
• Deepen understanding of provider relations, network operations, claims processes, and health plan administration.
• Act as a liaison between the health plan and provider community.
• Leverage expertise in managed care operations, provider servicing, claims resolution, reimbursement processes, and network management.

This individual contributor role is ideal for early to mid-career professionals who enjoy building relationships while solving operational challenges.

• Collaborate with providers and internal stakeholders to improve processes, resolve complex issues, and enhance overall provider satisfaction.
• Flexibility to work remotely if located within the Philadelphia Metro Area.
• Rewarded and recognized for performance in a challenging environment with clear direction for success.

Qualifications

• High school education or equivalent experience.
• 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.
• Intermediate proficiency with Microsoft Word, Excel, and PowerPoint.

Requirements

• 3+ years of provider relations, provider account management, or provider service experience (preferred).
• Experience working for a health insurance carrier, managed care organization (MCO), or third-party administrator (TPA) (preferred).
• Experience supporting provider networks and provider-facing operational initiatives (preferred).
• Experience with Medicare and Medicaid regulatory requirements (preferred).
• Experience analyzing provider trends and recommending operational improvements (preferred).
• Solid understanding of claims adjudication, reimbursement methodologies, provider appeals, and payment resolution processes (preferred).
• Knowledge of provider contracting, credentialing, and network development functions (preferred).
• Familiarity with provider data management, eligibility systems, and authorization processes (preferred).

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase and 401k contribution (subject to eligibility requirements).
• Salary range: $60,200 - $107,400 annually based on full-time employment.