Healthcare Advocate - Field-Based Position

UnitedHealth Group•Washington, DC

5d•$72,800 - $130,000•Onsite

About The Position

The Healthcare Advocate serves as a strategic partner to physicians, medical groups, IPAs, and hospitals, supporting accurate documentation and coding practices to ensure a complete and accurate health picture of members across government and regulated lines of business, including Medicare Advantage, Medicaid, and ACA. This role focuses on improving quality of care, closing gaps in care, and driving performance in Risk Adjustment and Quality programs through education, collaboration, and data-driven strategies. This is a field-based position covering travel territory based in Maryland and District of Columbia. Qualified candidates must reside in the Maryland/DC regional area to be considered.

Requirements

3+ years of healthcare experience with solid knowledge of medical terminology and clinical issues
2+ years of experience with EMR systems
Experience in a physician office, clinic, hospital, or similar medical setting
Demonstrated knowledge of ICD-10, HEDIS, and Stars programs
Demonstrated proficiency in MS Office (Excel, Word, PowerPoint) with ability to manipulate data, create documents, and deliver presentations
Demonstrated ability to identify automation opportunities and leverage AI to improve productivity and quality
Reside in the Maryland / Washington DC Regional Area to perform daily field travel requirements
Must be able/willing to travel approximately 80%25 of the time, this is a field-based position that required daily local state travel
Must have proof of a valid Driver’s License, reliable transportation, and current auto insurance to perform daily local state travel

Nice To Haves

Certified Professional Coder (CPC/CPC-A) or equivalent certification
CRC certification
2+ years of clinic/hospital or managed care experience
Experience in nursing (LPN, RN, NP)
Demonstrates advanced proficiency in MS Excel (pivot tables, advanced functions)
Experience in Risk Adjustment, HEDIS/Stars, and gap closure initiatives
Demonstrated knowledge of billing claims submission, and coding software
Project management experience
Previous experience in provider network management, physician contracting, healthcare consulting, or Medicare Advantage sales
Territory management experience

Responsibilities

Act as a trusted advisor and strategic partner to providers and medical groups, assisting in accurate documentation and coding to reflect members’ true health status
Travel independently across the assigned territory (approximately 80%25 field-based, with occasional overnight travel) to engage providers in Optum tools and programs that enhance quality of care for Medicare Advantage members
Responsible for gaining participation and deployment of Prospective Programs achieving business goals and metrics
Utilize data analysis to identify and target providers who would benefit from coding, documentation, and quality training resources
Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs and Hospitals
Develop and implement comprehensive, provider-specific plans to improve RAF performance, coding specificity, and gap closure
Manage end-to-end Risk Adjustment and Quality programs, including In-Office Assessment initiatives
Consult with provider groups on documentation and coding gaps; provide actionable feedback to improve compliance with CMS standards
Offer guidance on EMR/EHR system issues impacting documentation and coding accuracy.
Collaborate with multidisciplinary teams to implement prospective programs as directed by leadership
Educate providers on Medicare quality programs and CMS-HCC Risk Adjustment methodology, emphasizing the importance of accurate chart documentation for proper reimbursement
Support providers in ensuring documentation aligns with ICD-10 and CPT II coding guidelines and national standards
Deliver ICD-10 HCC coding training and develop tools for providers and office staff
Provide measurable, actionable solutions to improve documentation and coding accuracy
Partner with physicians, coders, and facility staff on Risk Adjustment and Quality education efforts
Assist in chart collection and analysis as needed