Valerie Hawn
Gibsonia,PA
Summary
A seasoned Provider Advocate with extensive experience in supporting and educating both large and small health systems. Earning a deep understanding of United Healthcare’s various lines of business, incentive programs, and contract reimbursement processes, I served as the primary point of contact for physicians and healthcare facilities. My role involved managing relationships with key stakeholders while ensuring their needs are met through efficient communication and responsive support. Known for my ability to solve complex problems, I continuously strive to optimize services and enhance the delivery of healthcare solutions. By staying current on internal processes, lines of business, priorities, and digital tools, I am able to provide valuable insights and ensure healthcare providers are well-equipped to navigate the evolving healthcare landscape. Through strong partnership and accountability, I work toward driving improvements, fostering collaboration, and contributing to the overall success of both health systems and insurer relationships.
Overview
14
14
years of professional experience
Work History
Senior Provider Advocate
United Healthcare Group
Pittsburgh, PA
05.2017 - 05.2025
- Build and maintain strategic relationships with physicians, hospitals, ancillary providers, and practice managers to support high-quality network performance.
- Lead efforts to improve the provider experience across platforms, enhancing ease of use for provider portal and contributing to future digital enhancements.
- Successfully managed large facilities such as Penn State Health and Allegheny Health Network and hosting monthly calls to assist and educate on topics and concerns.
- Educate providers and their staff on the policies and practices of claims processing and procedures and assisting in reducing billing errors.
- Appointed to appeals hearings to help make a decision if a claim should be denied or overturned by listening to medical director’s conclusions and testimony from members.
- Worked effectively with internal teams from various departments to coordinate effective solutions to questions and concerns.
- Managed complex caseloads with diligence while prioritizing tasks to ensure timely resolution of cases.
Relationship Specialist
United Healthcare Group
Cincinnati, OH
04.2013 - 05.2017
- Organized and carried out community events that educated Medicaid members on the benefits of United Healthcare’s Medicaid product.
- Worked closely with the Provider Relations team to assist providers in understanding the claims process and educating their staff.
- Collected and shared data to senior leadership regarding the membership growth of the Medicaid product and strategized ways to increase the market share.
- Attended industry meetings at a state level to help promote UnitedHealthcare’s benefits and programs for Ohio Medicaid members.
- Coordinated town halls for current members to join and share their feedback on how the health plan is working for them to assist in getting the care they need.
Worksite Wellness Consultant
Northside Pharmacies
Zanesville, OH
07.2011 - 04.2013
- Build and maintain strategic relationships with physicians, hospitals, ancillary providers, and practice managers to support high-quality network performance.
- Lead efforts to improve the provider experience across platforms, enhancing ease of use for provider portal and contributing to future digital enhancements.
- Successfully managed large facilities such as Penn State Health and Allegheny Health Network and hosting monthly calls to assist and educate on topics and concerns.
- Educate providers and their staff on the policies and practices of claims processing and procedures and assisting in reducing billing errors.
- Appointed to appeals hearings to help make a decision if a claim should be denied or overturned by listening to medical director’s conclusions and testimony from members.
- Worked effectively with internal teams from various departments to coordinate effective solutions to questions and concerns.
- Managed complex caseloads with diligence while prioritizing tasks to ensure timely resolution of cases.
Education
Bachelors of Science - Human Development And Family Studies
Kent State University
Kent, OH05-2005
Skills
- Microsoft Office
- Salesforce
- SPIRE
- CSP Facets
- ISET
- EDI
- Provider Portal
- Analytical reasoning
- Training delivery
- Interpersonal skills
- Creative and critical thinking
- Written communication
- Attention to detail
- Effective multitasking
- Time management
- Establishing effective relationships
Timeline
Senior Provider Advocate
United Healthcare Group
05.2017 - 05.2025
Relationship Specialist
United Healthcare Group
04.2013 - 05.2017
Worksite Wellness Consultant
Northside Pharmacies
07.2011 - 04.2013
Bachelors of Science - Human Development And Family Studies
Kent State University