Job Description

Careers with OptumRx. We're one of the largest and most innovative pharmacy benefits managers in the US, serving more than 12 million people nationwide. Here you'll fill far more than prescriptions. As a member of one of our pharmacy teams, you're empowered to be your best and do whatever it takes to help each customer. You'll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. There's no better place to help people live healthier lives while doing your life's best work.(sm)

The Payer Advocate Manager role is a Revenue Cycle Management position responsible in managing multi-payer relationships for Optum Infusion and Diplomat Organizations. The Payer Advocate is a strategic leader that will work within the Revenue Cycle team in create value add projects that will improve cash efficiency or strengthen the relationship of Revenue Cycle Organization with payers. A results-oriented leader that can build and cultivate strong relationships with the payers, effectively manage opportunities and meet business objectives that will drive profitability, healthy accounts receivable and reduction of bad debt through prompt claim processing. Key to this person's success will be to help provide a feedback loop to the internal organization where it needs to make changes/improvements in processes (i.e. Benefit verification, prior authorization, etc.) to insure proper billing and payment.

The Payer Advocate's main responsibilities are:

Build and Cultivate a lasting relationship with multi-payer organizations:

* Create and/or expand relationships with key personnel of multiple payer organizations
* Cultivate and maintain deep, broad and trustworthy strategic relationships with payers to achieve mutually beneficial goals and objectives
* Strategize ways on how to improve accounts receivable through available technology, process improvement developed and analytics.
* Communicate and resolve payment challenges with key partners at the payer level
* Lead workstreams to solve internal challenges that impact cash flow or resolution of claims.
* Perform business reviews with multiple payers on a regular schedule, may include light to moderate travel depending on business needs.

Ensure healthy accounts receivable for owned payers

* Report to the head of Revenue Cycle Management and Optum Infusion Executive team overall health of the payers assigned to the Payer Advocate.
* Create executive summaries of large client A/R aging status and highlight/quantify issues to be solved.
* Develop initiatives that will improve the revenue cycle through process improvement, training, quality improvement initiatives or technology utilization.
* Analyze and resolve cash flow challenges with payer contacts and device long term solutions that will ensure timely and efficient claims processing.
* Work closely with reporting team, project management and analytics to identify trends, propose process changes/solutions and generate outcomes
* Bottomline, the Provider Advocate will be responsible to improve the speed of cash collections, reduce the DSO, reduce write-offs, and reduce reserve accruals for assigned payers.

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:

* Bachelors Degree required, or 10+ years experience in Revenue Cycle Management
* 5+ years of healthcare management experience preferably in Home Infusion
* Strong knowledge of healthcare billing and coding requirements including an understanding of regulatory billing requirements from CMS.gov and private payers
* Must have strong written and verbal communication skills
* Excellent attention to detail
* You will be asked to perform this role in an office setting or other company location.
* If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas, In addition, employees must comply with any state and local masking orders.

Preferred Qualifications:

* Excellent analytical and problem-solving skills
* Ability to work across cross functional teams within the organization
* Self-starter and ability to take initiative and ownership of work
* Must have strong presentation skills
* Strong customer service and collaboration skills
* Strong knowledge base of home infusion therapy and home infusion revenue cycle operations

UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us.

You can learn more about all we are doing to fight COVID-19 and support impacted communities: click here.

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.