Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life’s best work. SM

The Associate Healthcare Advocate is responsible for a range of provider relations services within Optum. The Associate Healthcare Advocate will work as an extension of the local Provider Performance Team by aligning to geographical regions, medical centers and/or physician practices that manage a high volume of membership. The Associate Healthcare Advocate under the supervision of a Director/ Manager and or Mentor is responsible for the successful program implementation, compliance with network requirements, network assessment and selection, and program/product implementation.

Location: This is a field based role in the state of Pennsylvania and South New Jersey (Ventnor City, Somers Point, Bridantine and Absecon)

Primary Responsibilities:

• Manage 50-75 provider groups in a defined market, limited to groups with < 250 members
• Assist the licensed and/or certified staff/Director/HCA or Mentor in the review of medical records to highlight opportunities for the medical staff
• Locate medical screening results/documentation to ensure the closure of gaps in care/suspect medical conditions. Will not conduct any evaluation or interpretation of Clinical data and will be supervised by licensed and/or certified staff
• Activities may include data collection, data entry, quality monitoring, HQPAF submission and chart collection activities
• Partner with your leadership team, the practice administrative or clinical staff to determine best strategies to support the practice and our members
• Utilizing data analysis, identify and target providers who would benefit from our coding, documentation and quality training and resources
• Develop comprehensive, provider-specific plans to improve performance
• Anticipate customer needs and proactively develop solutions to meet them
• Optimize customer satisfaction, positively impact the closing of gaps in care and productivity
• Manage time effectively to ensure productivity goals are met
• Ability to problem solve, use best professional judgment, and apply critical thinking techniques to resolve issues as they arise Adhere to corporate requirements related to industry regulations/responsibilities
• Maintain confidentiality and adhere to HIPAA requirements
• Collaborate with doctors, coders, facility staff and a variety of internal and external personnel on a wide scope of Risk Adjustment and HEDIS education efforts
• Function independently, meeting with physicians to discuss OPTUM tools and programs focused on improving the quality of care for Medicare & Medicaid Advantage Members
• Mentor Health Service Coordinators
• Educate providers on how to improve their Risk Adjustment Factor (RAF) scores and HEDIS/STARS performance
• Other duties, as assigned

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.

Requirement Qualifications:

• High School Diploma/GED (or higher) OR 4+ years of a healthcare background with medical terminology familiarity of clinical issues
• 2+ years of experience with a healthcare background including use of medical terminology and familiarity of clinical issues
• 2+ years of experience with and knowledge of HIPAA compliance requirements
• 2+ years of experience with Microsoft Tools: Word, Excel and Outlook
• Ability to travel within assigned territory (day trips) 80% of the time within the state of New Jersey
• Currently reside within the area of South Jersey or the state of Pennsylvania
• 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 Qualifications:

• 3+ years of provider network management, physician contracting, healthcare consulting, Medicare Advantage sales or pharmaceutical sales experience
• Knowledge of Managed Care and Medicare programs; prior experience with commercial and Medicare regulations
• Experience working in a physician, provider, and/or medical office
• EMR and HEDIS knowledge and experience
• Project management experience

Soft Skills:

• Demonstrated ability to identify with a consumer in order to understand and align with their needs and realities.
• Demonstrated ability to perform effective active listening skills to empathize with the customer in order to develop a trust and respect
• Demonstrated ability to take responsibility and internally driven to accomplish goals and recognize what needs to be done in order to achieve a goal(s)
• Demonstrated ability to turn situations around and go above and beyond to meet the needs of the customer
• Ability to work independently and remain on task; ability to prioritize and meet deadlines

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 Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

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.

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