The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This Network Contracting role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. We’re building better, more effective provider networks every day. In this role, you’ll use your strong customer service orientation and knowledge of insurance claims to serve as an advocate for providers in our networks. As you do, you’ll discover the impact you want and the resources, backing and opportunities that you’d expect from a Fortune 6 leader.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
- Conduct provider outreach for outpatient behavioral health provider/agency/group network expansion
- When interacting with providers, manage provider expectations about timelines for contracting, credentialing, reimbursement, site audits, and the like
- Assemble provider agreements consisting of base agreements, appendices and addendums, fee schedules and related documents
- Issue provider applications, agreements and related documents to providers
- Gather completed provider applications and other documents that accompany the application, other documents required by state law and/or company policy; review these documents for completeness, accuracy, organize, and submit documents for credentialing
- Coordinate and follow-up with Optum Provider Relations Advocates to ensure timeliness of submission of applications and related documents
- Actively participate in Western Region Outpatient Behavioral Health Contracting Team Meetings
- Keep Director of Outpatient Behavioral Health Contracting of Western US/ Senior Outpatient Behavioral Health Contracting Manager Updated on timely basis about provider network development, contracting developments, rate negotiations, rate increase requests, emerging issues and the like
- Ability to learn and use proprietary and other software programs for sending, updating and storage of provider/agency/group contracts and numerous fee schedules and related contractual documents
- Develop, update and maintain numerous fee schedules
- Actively participate in joint Provider Relations – Outpatient Behavioral Health Contracting Meetings to ensure continuity of communication and coordination between
- Email and phone communication with internal and external customers throughout each day
- Ability to work in fast-paced work environment with multiple competing priorities and people from multiple functions within company and multiple external customers and ability to re-prioritize as work and customer deadlines and demands change throughout day and week
- Reports directly to Director of Outpatient Behavioral Health Contracting of Western US
- Light travel within the market
Are you ready for a challenge? You’ll be part of a performance driven, fast paced organization that is serving multiple markets and you’ll be charged with educating and building relationships with providers to evolve ongoing processes and programs.
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
- High school diploma or equivalent work experience
- 4+ years of health care/managed care experience
- 2+ years of provider contracting and/or provider network experience
- 1+ years of experience with Medicare and Medicaid regulations
- Proficiency with MS Word, Excel, PowerPoint and Access
- If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
- Undergraduate degree, preferably in business administration, public administration, healthcare administration, social services or related field
- Experience and knowledge with the Arizona and California behavioral health provider communities/markets
- Arizona Medicaid and Medi-Cal, including but not limited to state agencies, programs, laws, rules and regulations, related to Medicaid
- Proficient with Excel, and previous experience developing, updating and maintaining provider fee schedules
- Experience and knowledge of Optum tools including but not limited to:
- OHBS FACETS
- ePUFs (electronic provider update forms)
- SURE Reports
- FAT (Financial Analysis Tool)
- Fee Schedule Pricing Profiles
- Three years of experience:
- Working at a health plan / managed care organization contracting with behavioral health providers
- Negotiating behavioral health contracts between behavioral providers and health plans / managed care providers
- Medicaid contracting experience
- Working with behavioral health CPT codes
- Interacting with behavioral health professionals and/or behavioral health organizational leaders when working with prospective providers
- One year of experience:
- Using Excel to develop and analyzing behavioral health fee schedules using Excel
- Other important experience:
- Exceptional verbal and written communications
- Must be exceptionally well-organized self-starter who is able to learn quickly and often on own, work with minimal supervision and keep up with workload
- Ability to interact and communicate with individuals in a variety of positions (external customers: CEOs, CFOs, COOs, Contract Directors, and others; internal customers: Contract Managers, Provider Relations Advocates, Directors, Vice Presidents, and individuals from a wide variety of functional areas)
- Ability to follow-through with assignments and tasks is a MUST with both internal and external customers
- Ability to work with providers/agencies/groups and tell them “no” to various contract and reimbursement requests with respect and tact
- Strong internal and external customer service skills
- Strong negotiation skills
The health system is moving ahead. You can too as you help us build new levels of provider network performance. Join us. Learn more about how you can start doing your life’s best work(sm)
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SM
Colorado Residents Only: The salary range for Colorado residents is $53,300 to $95,100. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: provider contracting, Medicare, Medicaid