Healthcare Market Advocate - Phoenix, AZ

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)

OptumInsight is searching for a motivated, skilled Healthcare Advocate to join our team. As a member of the Payer & Government Health Management Solutions team within OptumInsight, you will consult with physicians throughout a predetermined set of Provider Groups in State of AZ. This specific position will be assigned to the northern Arizona territory.

Primary Responsibilities: 

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  Functioning independently, travel throughout a defined territory in the state of AZ to meet with medical groups and providers to discuss OptumInsight tools and programs focused on improving the quality of care for Medicare Advantage and Medicaid Members


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  Utilizing data analysis, identify and target medical groups, providers and staff who will benefit from our Medicare Risk Adjustment training and documentation/coding resources


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  Utilizing data analysis and consulting skills, identify deficiencies in physician encounter submission processes and develop comprehensive, provider-specific plans to increase encounter submission rates and accuracy resulting in improved outcomes and RAF performance


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  Educate providers on how to improve their Risk Adjustment Factor (RAF) scores, which measure their patients' health status


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  Reach out to physicians, medical groups, IPAs and hospitals, to build positive, long-term, consultative relationships


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  Develop comprehensive, Group and Provider specific work plans to increase their RAF performance and Quality Programs to ensure members are being seen, receiving preventative care and screenings for chronic conditions


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  Train providers on our Clinical Initiatives and Risk Adjustment programs and tools, and work toward the adoption of these programs in to their practices


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  Collaborate with medical groups, doctors, coders, facility staff and a variety of internal and external personnel on a wide scope of Quality and Risk Adjustment education efforts


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  Individual will maintain an office in the home, and will travel regularly to provider offices 

Required Qualifications:

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  3+ years of healthcare or managed care experience



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  Intermediate level of experience in healthcare network management, contracting and/or a group provider relations role



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  Intermediate level of experience in network development



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  Intermediate level of experience in medical reimbursement methodologies



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  Previous Tier 1 provider group experience



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  3+ years of experience making presentations and demonstrating training in front of an audience



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  Intermediate level of experience in MS Excel, Word and PowerPoint



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  Advanced communication skills required including ability to communicate effectively with various levels of leadership



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  Individual must have a reliable car; Mileage is reimbursed

Preferred Qualifications:

• 3+ years of experience interacting with providers 


• 3+ years of experience with analysis of healthcare data


• Undergraduate degree or equivalent work experience

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to 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, 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.

Job Keywords: Managed Care, Healthcare, Network Program Specialist, network requirements, network assessment, network selection, network data management, provider data analysis, medical claims, claims processing, claims resolution, medical coding, project management, Phoenix, Arizona, AZ