17 days old

Provider Relations Advocate - California

San Diego, CA 92101 Work Remotely
  • Job Code

You dream of a great career with a great company - where you can make an impact and help people.  We dream of giving you the opportunity to do just this.  And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our Service Centers, improve our Service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.


This opportunity is with one of our most exciting business areas: Optum -a growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader.


The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This Provider Relations Advocate role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. We're building better, more effective provider networks every day. In this role, you'll use your strong customer service orientation and knowledge of insurance claims to serve as an advocate for providers in our networks. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 6 leader.


This role is a Provider Relations Advocate for providers in the state of California. The incumbent must live in California, and our preference for location is in San Diego County.  


If you are located in California, you may have the flexibility to telecommute* as you take on some tough challenges.


Primary Responsibilities

  • Handling escalated provider claim and service issues and provider engagement activities that directly impact satisfaction and increase provider Net Promoter Score (NPS)

  • The position supports provider face to face engagement, education and training, including communications, live presentations, and information available to the provider network

  • Provider Medi-Cal trainings and ongoing education as guided by the State.  Provider training timelines are aggressive and based on stringent regulatory turnaround time requirements

  • The position plays a central role that acts as the organization's network liaison between the provider network and critical customers including health plans

  • Establishment and collaboration of Medical Behavioral Initiatives jointly with health plans

  • The position is responsible for the ongoing monthly monitoring of participating provider's managed care screening and enrollment process with the State, including follow up activities and regulatory mitigation efforts as a result of a participating provider's disenrollment

  • The position supports the network analysis of the existing provider network to drive provider recruitment and gap remediation

  • Collaboration with internal contracting staff on provider recruitment and network development

  • Involvement in regulatory responses to network shortfalls, including provider outreach and education. Provider Relation Advocates are required to respond and remediate any concerns or issues that are a result of the audits, and implement corrective actions plans as needed

  • Due to the nuances of health plan and county stakeholders, provider networks, and various geographic considerations in each county across the state, Provider Relation Advocates are expected to work in or in proximity of the service area (county) and be familiar with that market

Are you ready for a challenge? You'll be part of a performance driven, fast paced organization that is serving multiple markets and you'll be charged with educating and building relationships with providers to evolve ongoing processes and programs.

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. 



Posted: 2020-06-18 Expires: 2020-07-24

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Provider Relations Advocate - California

UnitedHealth Group
San Diego, CA 92101

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