Healthcare Advocate - Field Position

UnitedHealth Group•Jersey City, NJ

21d•$72,800 - $130,000•Hybrid

About The Position

The Healthcare Advocate provides provider relations services within Optum and works as an extension of the local Provider Performance Team. The role aligns with geographical regions, medical centers, and physician practices that manage high membership volumes. Under the supervision of a Director, Manager, and/or Mentor, the Healthcare Advocate supports successful program implementation, compliance with network requirements, network assessment and selection, and program and product implementation. Candidates must live in the Northern New Jersey regional area to meet daily field-based expectations. The position is field-based, with remote work flexibility for those located in Jersey City, NJ, and requires travel within the assigned territory approximately 75% of the time. The role manages provider groups in a defined market, limited to groups with fewer than 250 members. It supports care-gap closure by locating medical screening results and documentation, collecting and entering data, monitoring quality, submitting HQPAFs, and collecting charts. The Healthcare Advocate does not evaluate or interpret clinical data and is supervised by licensed and/or certified staff. The role works with provider and internal teams to strengthen documentation and coding accuracy, improve quality and productivity, and support Medicare and Medicaid Advantage members. The Healthcare Advocate establishes consultative relationships with physicians, medical groups, IPAs, and hospitals; educates providers about Medicare quality programs and CMS-HCC risk adjustment methodology; and supports alignment with ICD-10, CPT II coding guidelines, and national standards. Employees working remotely must follow UnitedHealth Group’s Telecommuter Policy. The position offers an annual salary range of $72,800–$130,000 based on full-time employment, plus benefits and incentive programs subject to eligibility requirements.

Requirements

At least 3 years of healthcare experience, with demonstrated knowledge of medical terminology and clinical issues.
At least 1 year of experience with EMR systems.
Demonstrated experience with MS Office (Excel, Word, and PowerPoint), including manipulating data, creating documents, and delivering presentations.
Demonstrated knowledge of ICD-10, HEDIS, and Stars programs.
Ability to identify automation opportunities and use AI to improve productivity and quality.
Ability to communicate, engage, and develop relationships across diverse audiences and collaborating teams, including providers and internal stakeholders.
Ability and willingness to travel approximately 75% of the time in the assigned Northern New Jersey territory, as business needs dictate.
Must live within the Northern New Jersey regional area to meet daily travel requirements.
Reliable personal transportation for daily travel requirements.
Proof of a valid driver’s license and current auto insurance.

Nice To Haves

Certified Professional Coder (CPC/CPC-A) or equivalent certification.
CRC certification.
At least 2 years of managed care experience.
Experience in a physician office, clinic, hospital, or similar medical setting.
Experience in Risk Adjustment, HEDIS/Stars, and gap-closure initiatives.
Experience in provider network management, physician contracting, healthcare consulting, Medicare Advantage sales, or pharmaceutical sales.
Project management experience.
Territory management experience.
Demonstrated knowledge of billing, claims submission, and coding software.
Nursing background (LPN, RN, or NP).
Advanced proficiency in MS Excel, including pivot tables and advanced functions.

Responsibilities

Manage provider groups in a defined market, limited to groups with fewer than 250 members.
Locate medical screening results and documentation to support closure of gaps in care and suspected medical conditions; do not evaluate or interpret clinical data.
Perform activities that may include data collection, data entry, quality monitoring, HQPAF submission, and chart collection.
Partner with leadership and practice administrative or clinical staff to determine strategies for supporting practices and members.
Use data analysis to identify and target providers who could benefit from coding, documentation, and quality training and resources.
Establish positive, long-term consultative relationships with physicians, medical groups, IPAs, and hospitals.
Provide measurable, actionable solutions to improve documentation and coding accuracy.
Anticipate customer needs and develop solutions proactively.
Improve customer satisfaction and positively affect care-gap closure and productivity.
Manage time effectively to meet productivity goals.
Use professional judgment and critical thinking to resolve issues.
Follow corporate requirements related to industry regulations and responsibilities.
Maintain confidentiality and adhere to HIPAA requirements.
Work independently with physicians to discuss Optum tools and programs focused on improving care quality for Medicare and Medicaid Advantage members.
Educate providers on Medicare quality programs and CMS-HCC Risk Adjustment methodology, including the importance of accurate chart documentation for proper reimbursement.
Support providers in aligning documentation with ICD-10 and CPT II coding guidelines and national standards.
Travel within the assigned territory on day trips approximately 75% of the time, as business needs dictate.
Perform other duties as assigned.