Provider Relations Advocate - Detroit and Kalamazoo, MI

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)

The Provider Relations Advocate is responsible for the full range of provider relations and service interactions within UnitedHealth Group, including working on end-to-end provider claim and call quality, ease of use of physician portal and future service enhancements, and training and development of external provider education programs. Provider Relations Advocates design and implement programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers.

Responsibilities also include directing and implementing strategies relating to the development and management of a provider network, identifying gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs, and may also be involved in identifying and remediating operational short-falls and researching and remediating claims.

Primary Responsibilities:

• Use pertinent data and facts to identify and solve a range of problems within area of expertise


• Investigate non-standard requests and problems, with some assistance from others


• Work exclusively within a specific knowledge area


• Prioritize and organize own work to meet deadlines


• Provide explanations and information to others on topics within area of expertise


• Travel 50% of the time to visit with providers in the Detroit or Kalamazoo metro area

Required Qualifications:

• 2+ year of experience working with providers in any of the following functions: billing, claims, provider relations and/or provider network experience


• 1+ years of experience with Medicare and Medicaid regulations


• Proficiency with Excel


• High School Diploma

Preferred Qualifications:

• Undergraduate degree


• 1 year of prior claims processing and issue resolution


• Ability to create and deliver an effective presentation


• Ability to work independently and remain on task


• Ability to prioritize and meet deadlines from multi-staff members within the department

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 17 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SM

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

Job Keywords: Medicare, Medicaid, claims, claims processing, provider relations, Detroit, MI, Michigan, Kalamazoo