The more you do, the more you learn. As you learn, you'll discover new opportunities to grow, make an impact, and bring your best every day. As a Provider Relations Advocate with UnitedHealth Group, you'll play a critical role in strengthening provider partnerships and improving the health care experience for providers and members alike.
We're building solider, more effective provider networks every day. In this role, you'll serve as a trusted resource and advocate for providers, using your customer service skills, managed care knowledge, and claims expertise to help resolve issues and improve the provider experience. You'll have the opportunity to deepen your understanding of provider relations, network operations, claims processes, and health plan administration while gaining exposure to a broad range of business partners and functions across the organization.
In this role, you will serve as a liaison between the health plan and provider community, leveraging your expertise in managed care operations, provider servicing, claims resolution, reimbursement processes, and network management. The ideal candidate has experience working for a health insurance carrier, managed care organization (MCO), or within a payer operations environment and understands the challenges providers face when navigating health plan processes.
What Makes This Role UniqueThis individual contributor role is ideal for early to mid-career professionals who have worked on the payer side of healthcare and enjoy building relationships while solving operational challenges. You'll collaborate with providers and internal stakeholders to improve processes, resolve complex issues, and enhance overall provider satisfaction.
If you are located within Philadelphia Metro Area, you will have the 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.
Required Qualifications:- High school education or equivalent experience
- 3+ years of experience working for a health insurance carrier, managed care organization, or payer operations team
- 1+ years of provider relations, provider services, network management, or provider network experience
- Experience resolving provider issues involving claims adjudication, reimbursement, eligibility, prior authorization, credentialing, or enrollment processes
- Experience collaborating with cross-functional operational teams including claims, network, provider services, and customer operations
- Intermediate proficiency with Microsoft Word, Excel, and PowerPoint
Preferred Qualifications:- 3+ years of provider relations, provider account management, or provider service experience
- Experience working for a health insurance carrier, managed care organization (MCO), or third-party administrator (TPA)
- Experience supporting provider networks and provider-facing operational initiatives
- Experience with Medicare and Medicaid regulatory requirements
- Experience analyzing provider trends and recommending operational improvements
- Solid understanding of claims adjudication, reimbursement methodologies, provider appeals, and payment resolution processes
- Knowledge of provider contracting, credentialing, and network development functions
- Familiarity with provider data management, eligibility systems, and authorization processes
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
