What makes your career greater with UnitedHealth Group? Growth opportunities among the variety of product lines and making an impact on the healthcare system ensures it will always be challenging and exciting.
UnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus:
UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, affordable benefits services.
UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.
UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.
Together, we're removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being.
The Network Contractor develops the provider network (physicians, hospitals, pharmacies, ancillary groups and facilities, etc.) yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners. Network Contractors evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties. In this role you will be expected to:
- Use pertinent data and facts to identify and solve a range of problems within area of expertise.
- Investigate non-standard requests and problems, with some assistance from others.
- Work exclusively within a specific knowledge area .
- Prioritize and organize own work to meet deadlines.
- Provide explanations and information to others on topics within area of expertise.
Come grow and thrive in our culture of innovation and ideas. Because there is no opportunity greater than the quest to help people live healthier lives.
- Undergraduate degree strongly preferred
- Strong complex problem resolution skills, strong communication skills both verbal and written
- 3+ years experience in a network management-related role, such as contracting or provider services.
- In-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS).
- 2+ years of experience in fee schedule development using actuarial models.
- 2+ years of experience utilizing financial models and analysis in negotiating rates with providers.
- At least an intermediate level of knowledge of claims processing systems and guidelines.
- 2+ years of experience in performing network adequacy analysis.
- Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information form others.
- Strong interpersonal skills, establishing rapport and working well with others.
- Strong customer service skills
UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier...