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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?
This role requires 50% travel in the state of Kansas.
In this role, you will be expected to actively support and implement health plan initiatives by guiding the Provider Advocate team in executing defined strategies and priorities. You will collaborate with internal stakeholders to ensure operational alignment, address provider group challenges, and contribute to measurable improvements in provider experience and service delivery. Your responsibilities will also include supporting the development and management of the provider network by identifying gaps in network composition and services to assist contracting and development staff in prioritizing needs. You may also be involved in identifying and remediating operational shortfalls and supporting claims resolution efforts. This role requires a proactive approach to team leadership, a commitment to advancing organizational goals, and a focus on building and maintaining trusting, sustainable relationships with providers to better serve the health needs of our members and their patients.
If you are located in Kansas, you will have the flexibility to work remotely
- as you take on some tough challenges.
Primary Responsibilities :
Guide and support team members in executing defined health plan initiatives, ensuring day-to-day alignment with operational priorities, performance expectations, and organizational standardsAssess and interpret provider needs and requirementsIdentify solutions to non-standard requests and problemsSolve moderately complex issues (claims, portal, provider data, etc.) while working under minimal guidance, seeking support for the most complex tasksProvide explanation and information on difficult issuesIdentify, organize, track, and deliver on identified solutionsSupport initiatives to achieve measurable service experience improvements in the health planSet Advocate field staff up for success through guidance, support, and issue resolutionCoordinate extensively with cross-functional internal teams to understand and address provider group challengesDevelop an intimate knowledge of provider practicesBring the "voice of the provider" to help shape internal initiatives and nurture relationshipsYou'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.
Years of post graduate experience can be substituted
Required Qualifications :
3+ years of experience with Medicare and Medicaid regulations2+ years of provider relations experienceExperience in a lead or supervisory roleExperience using reporting tools or systems to track issue management, monitor progress, and support project executionSolid understanding of Medicaid program operations, managed care, and provider engagement strategiesGeneral understanding of healthcare recovery processes, including payment adjustments, remittance advice, and how negative balances may impact provider experienceFamiliarity with claims and provider data platforms (e.g., NDB, Facets, CLM, OHBS, CSP Facets, DOC360, ICUE), or similar systems, with an understanding of how these tools support provider contracting, claims remediation, and reimbursement methodologiesFamiliarity with Kansas State's provider enrollment systems, revalidation processes, and provider / type specialty requirements for billing covered services under the State planProven ability to guide and support team members in executing defined initiatives, ensuring alignment with operational priorities, performance expectations, and organizational standardsProven exceptional communication and presentation skills, with the ability to engage diverse audiences and build trustProven ability to build and maintain effective relationships with internal and external stakeholdersProven self-directed and analytical, with strong critical thinking and problem-solving skillsProven comfort communicating across all organizational levels, from front-line staff to senior leadershipPreferred Qualifications :
Undergraduate degreeAll employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter PolicyPay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.