Optum · 15 hours ago
Provider Relations Advocate
United States
Full-time
Remote
Entry Level
$23.89/hr - $42.69/hr
1+ years expOptum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The Provider Relations Advocate will maintain a successful working relationship between Optum Serve and network providers, ensuring provider retention and resolving operational issues.
EducationHealth CareMedicalPharmaceutical
Responsibilities
Assess and resolve specific provider concerns, developing and implementing solutions that are beneficial to providers, LHI Customers and LHI
Negotiate fees that align provider needs and LHI business objectives. Educate providers on fee structures to ensure collaborative agreement and understanding of LHI Services and the fees associated with them
Staff Provider Relations Telephone Queue, adequately respond to and resolve incoming calls in the appropriate manner
Respond to Customer Satisfaction Surveys and Customer Complaints within the required time frame through investigation and problem solving that results in positive outcomes
Provide explanations and information to others on topics within area of expertise
Proactively review and maintain provider compliance documents to ensure active status within provider network
Collaborate with other departments to assign qualified providers to orders within the contractually allowed mileage radius of the patient's home zip code
Assist in complex end-to-end provider claims processing and resolution, including but not limited to, claims reprocessing, modifying orders, and adhering to contractual guidelines within claim requirements
Ability to resolve complex complaints within strict deadlines while ensuring accuracy and contractual compliance
Assist in efforts to enhance ease of use of physician portal and future services enhancements
Assist in identifying gaps in network composition and services to support network contracting and adequacy teams
Utilize relevant data and facts to analyze and resolve a variety of issues within area of expertise
Investigate and identify solutions to non-standard requests and problems, with some assistance from others
Manage and prioritize work effectively to meet deadlines, ensuring timely responses to leadership, providers, and assigned tasks
Provide explanations and information to others on topics within area of expertise
Use pertinent data and facts to identify and solve a range of problems within area of expertise
Educate providers on a wide range of topics to enhance their knowledge and compliance with policies, procedures, and best practices
Acts as a resource for others with less experience and promotes positive work environment
Coordinate meetings with providers to discuss a variety of topics, including JOC meetings
Attend and contribute to multi-department meetings
Ability to travel during business hours as needed
Perform other duties as assigned
Qualification
Required
High School Diploma/GED (or higher)
1+ years of experience in provider relations
1+ years of computer proficiency experience with Microsoft Office (Word, Excel, and Outlook) and the ability to access multiple web applications
Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI)
Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Ability to work an 8-hour shift between 8:00 am - 6:00 pm Monday through Friday based upon business needs
Ability to travel 10% of the time within 100 miles of territory assigned
Access to reliable transportation with a current and non-restricted state driver's license and state-required insurance
Preferred
Knowledge of negotiating rates and managing subcontractor relationships
Knowledge of MedNet
Ability to effectively manage provider accounts resulting in provider retention
Ability to develop strong professional relationships while demonstrating a clear understanding of complex business structures
Knowledge of medical terminology
Benefits
Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
401(k) Savings Plan, Employee Stock Purchase Plan
Education Reimbursement
Employee Discounts
Employee Assistance Program
Employee Referral Bonus Program
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
Company
Optum
Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.
10001+ employees
H1B Sponsorship
Optum has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (648)
2024 (559)
2023 (620)
2022 (851)
2021 (593)
2020 (438)
Funding
Current Stage
Late StageLeadership Team
Daniel Castillo
Chief Executive Officer, Optum Care Delivery
J
Jay Green
Chief Financial Officer
Recent News
2025-11-29
2025-11-19
2025-11-07
Company data provided by crunchbase