HCBS Relations Advocate, New Mexico

About the Role

UnitedHealthcare is seeking an HCBS Relations Advocate in New Mexico.

Key Responsibilities

• Resolve escalated provider issues related to enrollment, billing, and claims, managing cases through resolution.
• Conduct ongoing provider education and training sessions in both virtual and in-person settings.
• Serve as a subject matter expert for HCBS providers, including but not limited to ABCB, SDCB, EPSDT, Assisted Living, and Home Health.
• Support enhancements to the provider portal and contribute to future service improvements.
• Conduct annual provider audits, both virtual and onsite.
• Assist in the design and implementation of programs that strengthen collaboration between the health plan and provider community.
• Support the development and ongoing management of provider networks.
• Identify network gaps and service needs, providing insights to contracting and network development teams to support recruitment strategies.
• Build and maintain strong provider relationships to promote open communication and awareness of provider and member needs.
• Collaborate with internal stakeholders to identify provider challenges and develop solutions.
• Escalate issues to leadership as appropriate to ensure timely resolution for providers and members.
• Support providers with Electronic Visit Verification (EVV), including AuthentiCare, billing inquiries, care coordination, UHC Provider Resources and Turquoise Care requirements.
• Educate and build relationships with providers to evolve ongoing processes and programs.

Requirements & Tech Stack

• Approximately 25% business travel within New Mexico.
• Access to reliable transportation and valid US driver's license.
• Position requires expectation of working in the office as needed in Albuquerque, NM.
• Flexibility to work remotely if located in or within commutable driving distance to Albuquerque, Rio Rancho, Santa Fe.

Qualifications

• High School Diploma/GED.
• 2+ years of experience in health care or managed care.
• 2+ years of provider relations and/or provider network experience.
• 2+ years of experience with Medicare and Medicaid regulations.
• Intermediate level of proficiency in claims processing and issue resolution.
• Intermediate level of knowledge with Medicaid HCBS programs.

Preferred Qualifications

• Undergraduate degree.
• Proficiency with Microsoft Office tools (Excel, Word, PowerPoint).
• Familiarity with EVV systems or compliance oversight.
• Experience working with state agencies or managed care organizations.