Job Description

This position is Onsite. Our office is located at Fort Bend Primary Clinic, Sugar Land Clinic 2515 Cordes Dr., Sugar Land, TX 77479

Cuando se trata de salir adelante y tienes la voluntad de ganar, vamos a llamarlo gran potencial de carrera! Imagine being able to get answers to your health plan questions from someone who speaks the same language as you do. Or, the opposite, not being able to get the answers. At UnitedHealth Group, we want our customers to get those answers by speaking to one of our Bilingual Representatives. If you're fluent in English and Spanish, we can show you how to put all of your skills, your passions and your energy to work in a fast - growing environment.

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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together

The Sanitas Experience Specialist serves as UnitedHealthcare's onsite representative within designated Sanitas clinics, delivering a high-touch member and provider experience while strengthening the operational partnership between UnitedHealthcare and Sanitas. This role provides in-person support to members, assist providers and clinic staff with operational questions and issue resolution, and proactively identifies opportunities to improve end-to-end experiences and operational performance.

As an embedded member of the IFP Operations Strategy & Delivery (OSD) organization, the Sanitas Experience Specialist acts as a liaison between members, providers, clinic leadership, brokers, and UnitedHealthcare operational teams. This role combines member advocacy, provider support, operational problem solving, and relationship management to create a seamless healthcare experience

In this role you will work onsite at the clinics below. It may also be needed to travel. The additional clinics are within a 30 mile radius and you can anticipate needing to do so between 2-4 times per month

Fort Bend Primary Clinic, Sugar Land Clinic, 2515 Cordes Dr, Sugar Land, TX 77479

This position is full time. Employees are required to work during our normal business hours of 8:00 am - 5:00 pm.

Primary Responsibilities:

Member Experience & Advocacy

• Serve as the onsite UnitedHealthcare representative within assigned Sanitas clinics.
• Assist members with eligibility, benefits, claims, billing, provider access, referrals, authorizations, and other plan-related questions.
• Resolve member issues whenever possible at the point of care.
• Coordinate with internal UnitedHealthcare teams to manage and resolve member escalations.
• Educate members on available health plan resources, digital tools, and support services.
• Support community outreach, enrollment events, and broker activities as needed.

Provider & Clinic Support

• Partner with clinic staff and providers to resolve operational issues affecting patient care and administrative processes.
• Assist with eligibility verification, claims questions, referral processes, prior authorizations, credentialing inquiries, and provider service concerns.
• Coordinate with UnitedHealthcare functional teams to facilitate timely issue resolution.
• Build strong relationships with clinic leadership and staff to enhance the UHC-Sanitas partnership.

Operational Excellence

• Identify recurring member and provider pain points and escalate systemic issues for root cause analysis.
• Serve as a local operational expert for assigned markets and clinics.
• Track and communicate emerging trends, risks, barriers, and opportunities impacting member and provider experiences.
• Participate in process improvement initiatives designed to enhance operational effectiveness and reduce friction points.
• Support new market expansions, operational readiness activities, and implementation efforts as needed.

Relationship Management

• Maintain strong relationships with Sanitas leadership, clinic teams, brokers, and internal UHC stakeholders.
• Represent UnitedHealthcare professionally and consistently in all interactions.
• Help promote collaboration and alignment between UnitedHealthcare and Sanitas teams.

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 equivalent work experience.
• Must be 18 years of age OR older
• 2+ years of healthcare, health plan operations, member service, provider service, clinic operations, or related experience.
• Experience working directly with customers, members, patients, providers, or external partners.
• Knowledge of healthcare benefits, eligibility, claims, referrals, or authorization processes.
• Problem-solving and issue resolution skills.
• Ability to work independently with minimal supervision.
• Must be able to work at the location in the job description
• Bilingual fluency in English and Spanish
• Ability to work full time. Employees are required to work during our normal business hours of 8:00 am - 5:00 pm.

Preferred Qualifications:

• Experience supporting Individual & Family Plans, Medicare, Medicaid, or commercial health plans.
• Experience working in physician offices, clinics, provider operations, or care delivery settings.
• Experience managing escalated customer or provider issues.
• Knowledge of UnitedHealthcare operational processes and systems.
• Project, implementation, or process improvement experience.

Soft Skills:

• Relationship Building
• Member Focus
• Provider Partnership
• Communication
• Problem Solving
• Accountability
• Operational Excellence
• Adaptability
• Collaboration

Physical and Work Environment:

• Primarily onsite within designated Sanitas clinics.
• Frequent interaction with members, providers, and clinic leadership.
• Local travel between clinic locations and community events may be required.
• Occasional participation in business meetings outside assigned clinic locations.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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