Provider Relations Advocate - Remote from WA Job at UnitedHealth Group, Spokane, WA 99202

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Job Description

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 more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This Washington State Medicaid Behavioral Health 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 5 leader.


If you are located Washington State, you will have the flexibility to work remotely* as you take on some tough challenges


Primary Responsibilities:

  • Assist in end-to-end behavioral health provider claims and help enhance call quality
  • Assist in efforts to enhance ease of use of online provider portal and future services enhancements
  • Contribute to design and implementation of programs that build / nurture positive relationships between the health plan, providers, and practice managers
  • Support development and management of behavioral health provider networks
  • Help implement training and development of external providers through education programs
  • Identify gaps in network composition and services to assist network contracting and development teams


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.

Required Qualifications:

  • High school diploma or equivalent work experience
  • 4+ years of health care / managed care experience
  • 2+ years of Washington Medicaid provider relations and/or provider network experience
  • 1+ years of experience with Medicare and Medicaid regulations
  • Intermediate level of proficiency in claims processing, claim denial analysis and issue resolution
  • Proficiency with MS Word, Excel, PowerPoint, and Access
  • Residing in Washington State


Preferred Qualification:

  • Undergraduate degree


Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.


Washington Residents Only: The salary range for Washington residents is $56,300 to $110,400. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.


*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy


At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.


UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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