Independent Healthcare Benefits Consultant/Patient Advocate for UHC Plans
Independent Healthcare Consultant / Employee Benefits Advocate
Role Overview
The consultant will serve as an independent employee healthcare advocate, providing individualized and group-level guidance to help employees understand, navigate, and maximize their UnitedHealthcare (UHC) benefits.
Independence & Ethics
Must be independent of UnitedHealthcare and healthcare providers, disclose conflicts of interest, receive no carrier commissions, and adhere to strict confidentiality standards.
Core Services
UnitedHealthcare Cost Optimization & Benefit Maximization
Provide expert guidance on navigating UnitedHealthcare plan rules to maximize benefit utilization and cost recovery. This includes advising employees on strategic use of in-network versus out-of-network providers, understanding allowed amounts, balance billing risks, and the financial tradeoffs between provider choices. The consultant will assist employees in reviewing procedure coding and diagnosis information at a high level to help identify potential billing or claims issues, ensure services are billed consistently with covered benefits, and support successful claims adjudication. Guidance may include tips for pre-service cost estimates, prior authorization requirements, use of preventive care classifications, prescription formulary navigation, and best practices to minimize out-of-pocket costs.
ο§Benefits navigation and education
ο§ One-on-one employee advocacy
ο§ Claims and billing assistance
ο§ Cost optimization guidance
ο§ Preventive care and wellness navigation
Knowledge & Expertise
Deep familiarity with UHC plans, benefits approval tactics, and pharmacy benefits with some or all of the following certifications:
β’ CEBS (Certified Employee Benefit Specialist)
β’ Accredited Benefits Consultant
β’ Certified Health Advocate
Able to Conduct Employee Education
Group sessions, webinars, FAQs, and plain-language materials to help employees use benefits effectively.
Experience & Qualifications
Minimum 5+ years of healthcare advocacy or benefits consulting;
Engagement Model & Fees
Transparent fee structure (retainer, or hourly) β to be agreed before work starts.
Success Metrics
Improved employee understanding, reduced claims issues, increased preventive care usage, and positive employee feedback.
Apply Now
Apply Now
Role Overview
The consultant will serve as an independent employee healthcare advocate, providing individualized and group-level guidance to help employees understand, navigate, and maximize their UnitedHealthcare (UHC) benefits.
Independence & Ethics
Must be independent of UnitedHealthcare and healthcare providers, disclose conflicts of interest, receive no carrier commissions, and adhere to strict confidentiality standards.
Core Services
UnitedHealthcare Cost Optimization & Benefit Maximization
Provide expert guidance on navigating UnitedHealthcare plan rules to maximize benefit utilization and cost recovery. This includes advising employees on strategic use of in-network versus out-of-network providers, understanding allowed amounts, balance billing risks, and the financial tradeoffs between provider choices. The consultant will assist employees in reviewing procedure coding and diagnosis information at a high level to help identify potential billing or claims issues, ensure services are billed consistently with covered benefits, and support successful claims adjudication. Guidance may include tips for pre-service cost estimates, prior authorization requirements, use of preventive care classifications, prescription formulary navigation, and best practices to minimize out-of-pocket costs.
ο§Benefits navigation and education
ο§ One-on-one employee advocacy
ο§ Claims and billing assistance
ο§ Cost optimization guidance
ο§ Preventive care and wellness navigation
Knowledge & Expertise
Deep familiarity with UHC plans, benefits approval tactics, and pharmacy benefits with some or all of the following certifications:
β’ CEBS (Certified Employee Benefit Specialist)
β’ Accredited Benefits Consultant
β’ Certified Health Advocate
Able to Conduct Employee Education
Group sessions, webinars, FAQs, and plain-language materials to help employees use benefits effectively.
Experience & Qualifications
Minimum 5+ years of healthcare advocacy or benefits consulting;
Engagement Model & Fees
Transparent fee structure (retainer, or hourly) β to be agreed before work starts.
Success Metrics
Improved employee understanding, reduced claims issues, increased preventive care usage, and positive employee feedback.
Apply Now
Apply Now