Senior Provider Relations Advocate

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 . As a Senior Provider Relations Advocate, you will play a crucial role in supporting providers such as Aging Service Access Points (ASAPs) and Home and Community Based Providers (HCBS) within the Massachusetts market. You will focus on the Senior Care Option and One Care lines of business for UnitedHealthcare Community and State. This position requires a deep understanding of provider relations, healthcare regulations, and the ability to foster positive relationships with providers to ensure optimal service delivery and satisfaction. There are changes happening in health care that go beyond the basics we hear in the news. People like you and organizations like UnitedHealth Group are driving ever higher levels of sophistication in how provider networks are formed and operate. The goal is to improve quality of service while exploring new ways to manage costs. Here's where you come in. You'll use your solid 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 within Massachusetts, Rhode Island, or New Hampshire, you will have the flexibility to work remotely* as you take on some tough challenges.

Demonstrate a thorough understanding of policies and procedures impacting providers, including claims, appeals, complaints, benefits, regulatory requirements, and client business needs Develop and maintain solid relationships with ASAPs, HCBS, and Community Based Organizations (CBOs) Serve as the primary liaison to providers, ensuring positive, productive, and informative interactions Assist providers with claims issues, enhance the use of UHC's provider portal, and troubleshoot inquiries to ensure optimal performance Work collaboratively with Clinical, Sales, and other health plan and national departments to resolve issues and improve provider/customer satisfaction and growth Review provider contracts and audit systems for correct contract configuration Implement training and development programs for external providers through education initiatives by resolving provider claims issues, enhancing the use of UHC's provider portal, and troubleshoot provider inquiries for optimal performance Provide coaching, feedback, and guidance to team members to foster professional growth and improve performance Facilitate and lead quarterly Joint Operation Committee (JOC) meetings with select providers and their leadership teams Contribute to efforts to enhance the ease of use of the UHC provider portal and future service enhancements Design and implement programs that build and nurture positive relationships between the health plan, providers, and practice managers Identify gaps in network composition and services to assist network contracting and development teams In this role, you'll be part of a performance driven, fast paced organization that is serving multiple markets. You'll have frequent interactions with senior management and physicians as you communicate about ways 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.

High school diploma 2+ years of experience in a managed care organization, network management, healthcare operations or provider relations related