Sr. Provider Relations Advocate - FL - Multiple Locations

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM

Clinical

Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.(sm)

There are changes happening in health care that go beyond the basics we hear in the news. People like you and organizations like UnitedHealth Group are driving ever higher levels of sophistication in how provider networks are formed and operate. The goal is to improve quality of service while exploring new ways to manage costs. Here's where you come in. 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.

Primary Responsibilities:
  • Assist in end-to-end provider claims and help enhance call quality
  • Coach, provide feedback and guide others
  • Assist in efforts to enhance ease of use of physician 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
  • 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

This role is based in Florida (FL), and requires 90% local travel in Lake, Sumpter, and Marion counties.

In this role, you'll be part of a performance driven, fast paced organization that is serving multiple markets. You'll have frequent interactions with senior management and physicians as you communicate about ways 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 experience
  • 5+ years of health care / managed care experience
  • 3+ years of provider relations and/or provider network experience
  • 1+ years of experience with Medicare and Medicaid regulations
  • Intermediate level of proficiency in claims processing and issue resolution
  • Proficiency with MS Word, Excel, PowerPoint and Access
  • Willing to travel 90% - local travel

Preferred Qualification:
  • Undergraduate degree

Service Territory:
  • Lake County, Marion County, Sumpter County
  • Ocala, FL
  • Clermont, FL
  • The Villages, FL


Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

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

Job Keywords: Sr. Provider Relations Advocate, Physician Business Manager, PBM, Provider Relations, Advocate, Provider Support, Lake County FL, Sumpter County FL, Marion County FL, Clermont, Ocala, The Villages, FL

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