The Network Program Specialist â€“ Public Sector works directly with providers and internal and external stakeholders to effectively develop, implement and manage provider networks aligned with Optumâ€™s overall initiatives that support access, quality, usability and affordability for Optum public sector clients.
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:
This is not a telecommute opportunity
- 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.
- Bachelorâ€™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.
UnitedHealth Group - 12 months ago
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