Network Program Specialist
UnitedHealth Group - Golden Valley, MN

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The Network Program Specialist – Public Sector works directly with providers and internal and external stakeholders to effectively develop, implement and manage provider networks aligned with Optum’s overall initiatives that support access, quality, usability and affordability for Optum public sector clients.

Major Responsibilities

Assists with the development of a quality, cost-effective provider network that supports the goals of and obligations to Optum public sector clients and providers. Specific activities to support this include:
  • Engage in provider recruitment activities that support highly regulated and dynamic public sector programs and network goals, including mailing strategies, placement of outbound telephone calls and results tracking in Salesforce.
  • Organize and track incoming/outgoing provider contract documents in EchoSign; support a paperless contracting/credentialing approach.
  • Meet and/or exceed client service level provider accessibility expectations.
  • Performs network analysis and strategy development for new program implementations and expansions; identifies gaps in network composition and assists with network contracting efforts.
  • Utilize all software applications needed to adequately research provider set up issues and performs quarterly NMDB audits to ensure/maintain a quality network.
  • Document activities and report on progress, utilizing tools and job aids as requested by manager, on a consistent, timely and accurate basis.
  • Develop and maintain strategic business relationships with key internal and external public sector clients. Solves moderately complex problems and/or conducts moderately complex analyses.
  • Work with internal stakeholders to identify overall objectives and reporting format/ expectations and support delivery of such reports.
  • Submit periodic and ad hoc GeoAccess reporting requests.
  • Support provider communication guidelines - including those outlined in the Communications Committee policy documents such as recruitment letters and Plan Summaries.
  • Plan, conduct, and/or participate in special projects as directed by management or when supporting individual performance goals.
This is not a telecommute opportunity

Requirements Qualifications :
  • Bachelor’s Degree in related field or equivalent work experience.
  • 1 year provider contracting and/or provider relations experience, preferably in a health care setting, with an emphasis in public sector (Medicaid/Medicare).
  • 1 year project management/process improvement/quality experience.
  • 1 year experience in performing network adequacy analysis.
  • MS Office applications, including proficiency in Word, Excel, PowerPoint and Access.
  • Excellent verbal and written communication skills.
  • Resolve issues within a high matrix environment.
  • Involve and build strong relationships with all other relevant segments and units.
  • Strong customer service orientation and critical thinking skills.
  • Ability to calmly and effectively assist customers and represent Optum Physical Health in a professional manner at all times.

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