Provider Relations Advocate

Provider Relations Advocate at UnitedHealth Group

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Caring. Connecting. Growing together.

With these values to guide us our people are committed to making a meaningful difference in the lives of those we are honored to serve.

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Provider Relations Advocate

Requisition number 2355126

Job category Network Management

Primary location Corpus Christi TX

Date posted 05042026

Overtime status Exempt

Travel Yes 50 of the Time

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Explore opportunities with WellMed part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here you will be part of a team who shares your passion for helping people achieve improved health outcomes. Explore rewarding opportunities for physicians clinical staff and non-patient-facing roles. Join us and discover the meaning behind Caring. Connecting. Growing together.

The Physician Business Manager with WellMed is responsible for developing maintaining and servicing a high quality marketable and satisfied provider network within an assigned geographic area. The Physician Business Manager helps assigned providers operate successfully within our healthcare delivery model by providing strategic planning and tools to meet goals. This position is expected to build and sustain solid working relationships with cross functional departments vendors local network and assigned providers. The Physician Business Manager is accountable for overall performance and profitability for their assigned groups as well as ownership and oversight to provide redirection as appropriate.

Primary Responsibilities

Educate providers to ensure that they have the tools they need to meet quality risk adjustment growth as appropriate and total medical cost goals per business development plans

Ensure providers have in-depth understanding of WellMed Model of Care to include but not limited to contractual obligations program incentives and patient care best practices

Conduct detailed analysis of various reports by tracking and trending data to develop a strategic plan to ensure performance goals are achieved

Ensure the overall strategic plan incorporates interventions with internal departments or subject matter experts external vendors and others as needed

Participate in creation and execution of a local network development plan to assure network adequacy as needed

Conduct new provider orientations and ongoing education to providers and their staff on healthcare delivery products health plan partnerships processes and compensation arrangements

Maintain open communication with providers to include solutions for resolution and closure on health plan issues related to credentialing claims eligibility disease management utilization management quality and risk adjustment programs

Conduct provider meetings to share and discuss economic data troubleshoot for issue resolution and implement an escalation process for discrepancies

Collaborate with provider groups to develop execute and monitor performance and patient outcomes improvement plans

Collaborate with Medical Director to monitor utilization trends and profit pools and share results with assigned PCPs

Handle or ensure appropriate scheduling agenda materials location meals and minutes of provider meetings as needed

Collaborate with contracting team to ensure provider data is correct and provider directories include any needed updates

Complete Practitioner Data Forms and Provider Change Forms as needed

Represent WellMed UHG by holding company sponsored provider events summits learning sessions

Provide information and participate in management meetings as requested

Regularly meet with cross functional team to create revise and adjust strategy for assigned provider groups to meet overall performance goals

Provide support to maintain and develop ongoing value related to the WellMed Value Proposition

Introduce and advocate company resources to facilitate practice optimization

Ability to travel as needed 50 - 75 within market

Youll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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