Provider Relations Advocate, Full Time - Days

UChicago Medicine • Chicago, IL

1d • $86,800 - $101,200 • Hybrid

About The Position

The Provider Relations Advocate develops and maintains relationships with UChicago Medicine hospitals, physicians, and third-party payers to support managed care contractual relationships. The role supports provider services, contract education and communication, reimbursement, payer relations, and contract compliance. It manages operational and administrative payer relationships and helps coordinate meetings to resolve issues.

The position ensures delivery of provider services related to payer contract updates, policy changes, reporting, and process improvement. It partners with OMC team members on contract implementation, monitoring and enforcement, and value-based care initiatives. The role also supports education for providers and revenue cycle staff on payer contract terms, value-based care arrangements, and insurance market changes.

This is a full-time, day-shift role in Managed Care, based in Hyde Park, with a hybrid remote work arrangement. The employee must be able to come onsite to Hyde Park and Burr Ridge as needed.

Requirements

• Bachelor’s degree required; relevant work experience may be considered in lieu of a bachelor’s degree.
• Five years of managed care healthcare experience, including provider relations and claims or network management experience in a provider or third-party payer setting.
• Direct experience working between providers and third-party payers to facilitate issue resolution.
• Strong knowledge of hospital and physician revenue cycle operations.
• Thorough understanding of physician and hospital coding, claim forms, and payer EOBs.
• Ability to maintain strong relationships with internal providers and external payers through relationship management and a strong customer service mindset.
• Self-starter who can take initiative and ownership of work.
• Strong written, verbal, and presentation skills.
• Ability to adapt to rapid change and manage multiple demanding priorities with strong time and project management skills.
• Strong attention to detail and organizational skills.
• Ability to multitask, problem-solve, facilitate discussions and resolution, and collaborate across workstreams and projects.
• Ability to work across a broad network of operational teams and provider locations.
• Advanced working knowledge of Microsoft Office, particularly Word, Excel, and PowerPoint.

Nice To Haves

• Experience in a multi-facility health system, large academic medical center, or insurer environment.
• Experience and knowledge of value-based care initiatives, including risk contracts and population health management.

Responsibilities

• Build and maintain provider and third-party payer relationships that support operational efficiency, compliant contract administration, education, and satisfaction.
• Schedule regular meetings and develop and present educational materials for UCM hospitals and physicians on payer contract terms, value-based care requirements and performance, operational processes, and payer or insurance policy and market changes.
• Serve as the primary liaison between UCM hospitals and physicians and Commercial, Value Based, Medicare Advantage, and Managed Medicaid payers to resolve operational and payer compliance issues.
• Manage monthly payer joint operating committee and operational meetings, including scheduling, agendas, minutes, and follow-up on action items; identify and escalate significant issues for remediation and root cause analysis and stay informed of payer updates.
• Support the Director of Provider and Payer Relations in facilitating key OMC meetings, including Technical Workgroup and OMC Revenue Cycle/UCPG Revenue Cycle meetings.
• Coordinate periodic meetings with internal UCM stakeholders to share managed care contract updates and market trends.
• Collaborate with the Technical Workgroup to provide the Contracting team feedback on policy, operational, and claims issues, including data and analysis to support contract negotiations.
• Support successful contract implementation, monitoring, and enforcement and value-based care contracting initiatives.
• Provide ongoing education to providers and revenue cycle staff regarding payer contract terms, value-based care arrangements, and insurance market changes.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level