UnitedHealth Group Network Contract Specialist - Overland Park, KS in Overland Park, Kansas
Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)
Supporting the development of the provider network (physicians, hospitals, pharmacies, ancillary groups & 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. Evaluates and supports the negotiation of contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Establishes and maintains strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties.
Works closely with all internal and external partners to ensure effective and appropriate geographically competitive, broad access, stable network
Recommends changes, training and process improvements to prevent future errors
Perform analysis, supports strategy development, and implementation
Support regulatory and out-of-network daily initiatives
Obtain, validate and analyze network data as needed
Demonstrate understanding of contract language in order to support financial and operational impact and legal implications of requested contract changes.
Establishes and cultivates business relationships with associated partners
Connecting with Providers to finalize contracting and credentialing process
Assist in operationalizing contracts from contracting through implementation leveraging standardized tools and quality processes end to end
Maintains contracts, including making changes and updates using various systems review contract language, compare and identify changes from current language
Handles internal and external communication relating to contract documents, updates and issues
Coordinate receipt and processing for payor contracts, delegation agreements, memorandums of understanding (MOUs), letters of agreement (LOAs), termination notices, extension letters, etc.
Other duties as assigned
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.
Undergraduate degree or 4 years of equivalent work experience
Customer Service, Claims, or Provider Relations Experience
2+ years experience planning projects, building relationships, and working with data sets
Proficiency in Microsoft Office suite
Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
2+ years’ experience with claims processing or resolution or medical coding
1+ years of experience working in regulatory, vendor management, or network environment
Project Management Skills
Excellent verbal and written communication skills
Ability to convey complex information to others and make it more easily understood
Excellent time management, organizational, and prioritization skills and ability to balance multiple priorities
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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 8minds 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)
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.