Sr Provider Relations Advocate - Pacific Northwest ...

UnitedHealthcare is a company that''s on the rise. We''re expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn''t about another gadget, it''s about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life''s best work.(sm) The Sr. Provider Relations Advocate is accountable for the full range of provider relations and service interactions within UHG, including working on end-to-end provider claim and call quality, ease of use of physician portal and future service enhancements, and training & development of external provider education programs. The Sr. Provider Relations Advocate designs and implements programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. The successful candidate will direct and implement strategies relating to the development and management of a provider network. The Sr. Provider Relations Advocate identifies 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. If you are located in Pacific Northwest Region, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: Gather data from relevant systems (e.g., claims; data warehouse; payment integrity; EDI/Portal reporting; customer relations systems) and business partners (e.g., contracting; claims operations) Collaborate and/or participate in discussions with colleagues and business partners to identify potential root cause of issues Demonstrate understanding of providers'' business goals and strategies to facilitate the analysis and resolution of their issues Analyze data to determine root cause of issue (e.g., identify trends and patterns; identify outliers and anomalies) and/or escalate problem to appropriate group for further analysis as necessary Work with relevant internal stakeholders to identify obstacles and barriers identified by providers, and methods for removing them Work with relevant internal stakeholders to develop solutions to underlying problems/issues identified by providers Involve leadership and/or escalate issues as necessary to implement provider solutions Coordinate with internal and/or external resources to implement provider solutions Ensure that provider solutions meet their needs and increase provider satisfaction (e.g., simplify processes) Communicate provider updates and information to applicable stakeholders (e.g., health plans; internal partners; providers; account managers; employer groups) regarding research and resolution of issues within applicable defined metrics (e.g., turnaround time) Ensure that provider data (e.g., demographics; fee schedule) is accurate through audits, re-credentialing, and/or outreach Assesses and interprets customer needs and requirements. Identifies solutions to non-standard requests and problems. Solves moderately complex problems and/or conducts moderately complex analyses. Works with minimal guidance; seeks guidance on only the most complex tasks. Translates concepts into practice. Provides explanations and information to others on difficult issues. Coaches, provides feedback, and guides others. Acts as a resource for others with less experience 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: Undergraduate degree or equivalent work experience 4+ years of provider relations, contracting, and / or provider network experience 3+ years of experience with Medicare and Medicaid regulations Intermediate level of proficiency in claims processing and issue resolution Intermediate level of proficiency with MS Word, Excel, PowerPoint and Access Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation Preferred Qualifcations: Exceptional presentation, written and verbal communication skills Ability to work independently and remain on task Good organization and planning skills Ability to prioritize and meet deadlines from multi-staff members within the department To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment Careers with UnitedHealthcare. Let''s talk about opportunity. Start with a Fortune 5 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) *All Telecommuters will be required to adhere to UnitedHealth Group''s Telecommuter Policy. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Created: 2026-03-07