HCBS Provider Advocate – Hybrid in MI

Requisition Number: 2272497
Job Category: Network Management
Primary Location: Detroit, MI, US
(Remote considered)

Doctor consulting nurse at nurse station.

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. 

UnitedHealthcare Community Plan of Michigan Home and Community Based Services ( HCBS) Provider Advocate is responsible for working on end-to-end HCBS and In Lieu of Services (ILOS) provider claims, ease of use of UnitedHealthcare Self Help tool, training and development of external provider education programs. HCBS Provider Advocates design and implement programs to build and nurture positive relationships between the health plan, and our  HCBS and ILOS providers. 

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

The main objectives of this position are to ensure customer satisfaction, help providers effectively use our services, serve as the provider advocate within UnitedHealthcare and execute highly effective, highly responsive issue resolution and communication. 

If you are located in or within commutable driving distance to Pontiac or Detroit, MI, you will have the flexibility to work remotely* as you take on some tough challenges. 

Primary Responsibilities:

  • Training and on-going education of providers on policies and procedures 
  • Participate in collaborative regional/association meetings with other Managed Care entities and providers 
  • Trouble shooting provider concerns internally with the expectation of timely resolution of issues 
  • Traveling to provider offices to build relationships, up to 75% travel within specific region in Michigan 
  • Presentations to train providers on new requirements, or reiterate existing requirements 
  • Documenting outreach, as applicable 
  • Educate providers regarding appropriate claims submission requirements, coding updates, etc. 
  • Analyze data from call center to identify trends and guide the development of strategies to improve provider satisfaction. 
  • All other duties as assigned to assist the UHCCP of Michigan 

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:

  • Minimum of a High School Diploma or GED
  • 2+ years of work experience in healthcare/claims 
  • 2+ years of experience managing multiple projects, timelines, and competing priorities
  • 1+ years of experience tracking, trending, and reporting on metrics 
  • Intermediate+ level proficiency with MS Office experience including Excel, Word, and PowerPoint 
  • Resides in the State of Michigan 
  • Reliable transportation to travel to provider offices to build relationships, up to 75% travel within specific region in Michigan

Preferred Qualifications:

  • 2+ years of experience in Provider Relations 
  • Are located in or within commutable driving distance to Pontiac or Detroit, MI
  • Experience and knowledge with Indiana Michigan Medicaid 
  • Experience and knowledge with Long-Term Services and Supports providers 
  • Proven solid analytical skills 
  • Proven excellent written and verbal communication and presentation skills 
  • Proven ability to balance multiple high priority projects and meet quick deadlines 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy 

The salary range for this role is $59,500 to $116,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. 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 (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives. 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.    

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. 

Additional Job Detail Information

Requisition Number 2272497

Business Segment UnitedHealthcare

Employee Status Regular

Job Level Individual Contributor

Travel Yes, 50 % of the Time

Additional Locations
Pontiac, MI, US

Overtime Status Exempt

Schedule Full-time

Shift Day Job

Telecommuter Position Yes

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