Network Contractor -- West Chester, OH
UnitedHealth Group - West Chester, OH

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What will inspire your life's best work(tm)? Growth opportunities among the variety of product lines and making an impact on the healthcare system ensures it will always be challenging and exciting. The Network Contractor develops the provider network (physicians) 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 Physician 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.
Works with Network Managment physician team, for all UHC products, to maintain and expand network of professional providers.

Office based position in the West Chester, OH office.

- Undergraduate degree or equivalent experience
- 3+ years experience in a network management-related role, such as contracting or provider services.
- Knowledge of Medicare reimbursement methodologies

- Experience utilizing financial models and analysis in negotiating rates with providers.
- At least an intermediate level of knowledge of claims processing systems and guidelines.
- 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

- Intermediate level use of MS Word and Excel

Job Keywords: Healthcare, Provider Network, Physician Network, Network Management, Reimbursement Methodologies

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