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Behavioral Health Provider Network Recruiter - San Diego, CA

UnitedHealth Group

San Diego, CA
Job Code:
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Job Details

733997 Behavioral Health Provider Network Recruiter San Diego CA

Behavioral Health Provider Network Recruiter - San Diego, CA (733997)

Position Description

Position Description:

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)

The Network Recruiter is responsible for a full range of provider relations and service interactions. They will works with the Director of Behavioral Health Network and  Manager of Provider Services on identifying network gaps, needs, and recruitment strategies; identify and execute processes needed to recruit applicant; work with Provider Network Department staff to align recruitment efforts and maintain and ensure the integrity of provider databases; and respond to provider inquiries with exceptional customer service to providers, County partners, peers, staff in other departments and the general public. 

As part of this position, you will be required to be granted and maintain access to the County of San Diego's electronic health record, Cerner Community Behavioral Health (CCBH ). In addition please note that if you are currently employed by the County of San Diego, further review of your application will need to occur to ensure that there is not a conflict of interest.

Primary Responsibilities:

  • Accountable for a full range of provider relations including engagement with and development of  prospective providers
  • Design and implement strategies to increase the membership of providers in the network
  • Create and execute a marketing plan to build and nurture provider network 
  • Identify needs in provider network, incorporating potential gaps related to composition, services, or geographical needs
  • Support leadership in establishing and maintaining strong business relationships with Hospitals, Physicians, Pharmacies and Ancillary providers, and ensure the network composition includes an appropriate distribution of provider specialties
  • Identify, coordinate and participate in outreach events to educate community providers on the benefit of network membership
  • Establish recruiting requirements by studying organization plans and objectives and meeting with managers to discuss needs
  • Build applicant sources by researching and contacting community services, colleges, employment agencies, recruiters, media, and internet sites and  provide organization information, opportunities, and benefits while making presentations and maintaining rapport
  • Attract applicants by placing job advertisements, contacting recruiters, using newsgroups or job sites
  • Improve organization attractiveness by recommending new policies and practices, monitoring job offers and compensation practices, and emphasizing benefits and perks
  • Update job knowledge by participating in educational opportunities, reading professional publications, maintaining personal networks, and participating in professional organizations
  • Must possess the following skills-Phone and Interviewing Skills , Recruiting, , People Skills, Strong decision-making, Professionalism, Good Judgment, Organizational Skills, Project Management
  • Support Diversity, Knowledge on Employment Law, Focus on Results
  • Assume additional responsibilities as assigned
Additional Responsibilities may include:
  • Complete administrative processes related to the application, credentialing, contacting and re-credentialing of providers
  • Review all provider applications and  documents to ensure compliance with the credentialing criteria for inclusion in the different networks
  • Track credentialing process and send provider the completed contract once process is complete
  • Run reports from provider databases to track credentialing and re-credentialing activities for a variety of provider types
  • Return the signed fully executed contract to new providers in the Fee For Service and TERM networks
  • Track providers’ malpractice insurance, DEA, and licensure renewals to ensure they are current/active
  • Facilitate the resolution of  credentialing  issues
  • Coordinate and complete external and internal termination notification requirements
  • Periodically review state and federal bulletins for provider sanctions and review provider disbarment reports notifying Manager of outcome
  • Attend and participate in meetings to achieve departmental and interdepartmental goals and objectives
  • Triage provider related issues and escalate complex problems when necessary to Manager
  • Respond to claim issues by assessing fee schedule and contract configuration, procedure and diagnosis code questions, review modifiers and other claim form components in order to determine payment accuracy
  • Organize provider files so they may be easily reviewed by staff, credentialing committee and external review bodies
  • Accurately enter and  maintain  Provider data in multiple databases to be used for directories,  payments, mailing labels and reports
  • Document communication with providers in designated databases; assist in managing the integrity of databases by using contacts with providers to verify and update provider files
  • High School diploma/GED
  • Previous experience in managed care credentialing  and/or  network recruitment
  • Excellent computer skills including Excel, Microsoft Word, Outlook
  • Access to reliable transportation during standard business hours.
Preferred Qualifications:
  • Associates Degree of higher
  •  Data entry experience
  • Experience working in an environment that requires coordination of benefits and working with multiple groups and resources
  • Previous experience ins behavioral health
  • Previous sales experience
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

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.

Keywords: UHG, Behavioral Health Provider Network Recruiter, San Diego, CA, County of San Diego, network recruitment, managed care, behavioral health

Job Details

  • Contest Number733997
  • Job TitleBehavioral Health Provider Network Recruiter - San Diego, CA
  • Job FamilyNetwork Management
  • Business SegmentOptum Consumer Solutions Group

Job Location Information

  • San Diego, CA
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelYes, 25 % of the Time
  • Telecommuter Position
  • Overtime StatusNon-exempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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