Tribal Operations - Provider Advocate - Remote

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.

This position is full - time (40 hours / week) Monday - Friday. It may be necessary, given the business need, to work occasional overtime. You'll enjoy the flexibility to work remotely.

If you are located in New Mexico, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Confirm contract compliance to meet the needs of the Turquoise Care contract
• Experience working with providers/facilities to conduct advocacy actives with ITU's
• Work with cross-functional teams within UnitedHealthcare including but not limited to behavioral health, physical health, dental and vision
• Work with internal groups to identify, understand, and / or improve internal tools, resources, systems, and capabilities that can maximize provider and member experience
• 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

Included in this role is the full range of provider relations and service interactions within UHG, including working on end-to-end problem resolution. Identifies network gaps and assists in the development and implementation of strategies to fill these gaps.

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:

• High School Diploma / GED (or higher)
• 2+ years of experience with claims processing in Facets
• Working knowledge of Medicaid or previous MCO experience
• Expert in suite of Microsoft office programs
• Proven ability to communicate clearly and professionally with Providers
• Designated workspace inside the home with access to high - speed internet availability
• Currently reside in New Mexico
• Ability to travel locally up to 25% of the time

Preferred Qualifications:

• Experience with Tribal providers (ITU)
• Speak one or more Native American languages
• Proven excellent time management, organizational, and prioritization skills and ability to balance multiple priorities

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

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.