Provider Relations Advocate - Boston, MA

UnitedHealth Group•Boston, MA

8d•Hybrid

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Provider Relations Advocate is responsible for the full range of provider relations and service interactions within Optum, including working on end-to-end provider issue resolution, ease of use of physician portal, future service enhancements, and training & development of external provider education programs. Provider Relations Advocates socialize and implement programs to build and nurture positive relationships between the health plan, providers (physician, facilities, etc.) and practice managers. Responsibilities may also include the project management of complex issue resolution involving cross functional teams. If you live within a commutable distance to Boston, MA you will have some flexibility to work remotely as you take on some tough challenges. You’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.

Requirements

High school diploma/GED
2+ years of provider relations and/or provider network experience
Intermediate level of proficiency in billing / coding / claims analysis; claim issue resolution
Intermediate level of proficiency with MS Excel
Reside in the state of Massachusetts
Valid driver’s license

Nice To Haves

2+ years of experience with Medicare and Medicaid regulations
2+ years of presentation experience
Experience with providers in this region
Provider Relations experience professional and facility levels

Responsibilities

Engagement with internal resources to project manage provider issue resolution (claims, credentialing, provider set-up)
Provider education and outreach regarding policies, processes, and ease of use of our provider self-service portal, provider express
Delivery of external provider training and education programs either in-person, virtually or through larger external provider events
Build and nurture trusted relationships with high touch and territorial providers in assigned counties for all LOB
Establish recurring monthly meetings with assigned high-touch providers to discuss outstanding issues and the appropriate escalation path for resolution