What are the responsibilities and job description for the Provider Advocate, Home and Community Based Services position at UnitedHealthcare?
UnitedHealthcare is seeking a dedicated professional to serve as a HCBS Provider Advocate. This role requires strong provider relations and network experience, with the ability to work independently and prioritize tasks effectively.
The successful candidate will be responsible for working on end-to-end HCBS provider claims, easing referrals to providers, and designing programs to build positive relationships between health plans and providers.
- Serve as the primary contact for health plan services issues, including claims, authorization, and provider communication.
- Build relationships with providers to resolve claims and prior-authorization-related issues.
- Collaborate with Claims SMEs to review claims and address root cause issues.
- Communicate FAST ticket results to providers within 48 hours of receiving notification.
- Monitor the Provider Advocate mailbox daily and respond to inquiries submitted by HCBS providers.
This is a fast-paced environment requiring multitasking, attention to detail, and excellent organizational skills. The role offers flexibility to work remotely and requires a resident of Idaho.
Required Qualifications:
- 2 years of provider relations and/or provider network experience, preferably HCBS.
- Intermediate level of proficiency in claims processing and issue resolution.
- Intermediate knowledge of Medicare and Medicaid guidelines.
- Proficiency with MS Word and Excel.
- Proven good organization and planning skills.
- Ability to travel 25%.
- Resident of Idaho.
Preferred Qualifications:
- Provider-facing experience.
- Knowledgeable about healthcare and managed care/health plans.
- MS Access and PowerPoint skills.
- Exceptional presentation, written, and verbal communication skills.
The salary range for this role is $59,500 to $116,600 annually based on full-time employment. UnitedHealth Group complies with all minimum wage laws as applicable. 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.
Salary : $59,500 - $116,600
