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Senior Advocate for Provider Relations

2 months ago

Hemet, California, United States UnitedHealth Group Full time

Opportunity Overview:

For those eager to shape the future of healthcare, this is your chance. We are advancing beyond conventional care to create health programs that are integrated throughout the entire spectrum of care. Become part of a mission that emphasizes Caring, Connecting, and Growing together.

At Optum's Pacific West region, we are transforming healthcare with a commitment to health equity, affordability, quality, and convenience. Our focus spans from California to Oregon and Washington, as we strive to assist over 2.5 million patients in leading healthier lives while enhancing the overall functionality of the health system for everyone.

As a Senior Advocate for Provider Relations, you will serve as a crucial link between Optum and the affiliated physicians within our Independent Physician Association (IPA) network, facilitating their operational success and performance. This role entails ongoing education, support, training, and troubleshooting for physicians and their teams.

Key Responsibilities:

  • Act as the primary contact for the physician network, ensuring responsiveness to their needs while being well-versed in incentive programs, contract reimbursements, and internal processes.
  • Monitor the performance of assigned primary care physicians (PCPs), identify those underperforming, and collaborate with IPA leadership to formulate improvement plans.
  • Address and escalate issues as necessary.
  • Stay informed about providers interested in engaging with Optum for new business opportunities and market dynamics affecting the IPA.
  • Work in partnership with offices and the Optum growth team to enhance membership growth and retention.
  • Respond promptly to provider inquiries, collaborating with other departments to resolve issues and keeping providers updated throughout the resolution process.
  • Foster collaborative relationships with IPA physicians and their office personnel.

In this role, you will be recognized and rewarded for your contributions in an environment that challenges you while providing clear guidance on achieving success and opportunities for professional development.

Qualifications Required:

  • Minimum of 2 years of experience in healthcare or managed care.
  • At least 2 years of experience in provider relations or network management.
  • Familiarity with Medicare and Medi-Cal regulations.
  • Understanding of healthcare billing systems.
  • Intermediate proficiency in claims processing and issue resolution.
  • Proficient in Microsoft Office Suite.
  • Willingness to work a hybrid schedule.
  • Able to travel within the designated territory.

Compensation and Benefits:

Compensation for this role is competitive and based on various factors, including local labor markets and individual qualifications. UnitedHealth Group offers a comprehensive benefits package, including incentive programs and retirement contributions, all subject to eligibility requirements.

At UnitedHealth Group, our mission is to help individuals lead healthier lives and improve the healthcare system for all. We are dedicated to addressing health disparities and enhancing health outcomes, ensuring that everyone has the opportunity to live their healthiest life.

Diversity and Inclusion:

OptumCare is an Equal Employment Opportunity/Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to any characteristic protected by law.

OptumCare maintains a drug-free workplace, and candidates must pass a drug test prior to employment.