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Healthcare Provider Network Contractor - Cypress, CA

UnitedHealth Group


Location:
Cypress, CA
Date:
11/17/2017
2017-11-172017-12-16
Job Code:
733349
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Job Details

733349 Healthcare Provider Network Contractor Cypress CA

Healthcare Provider Network Contractor - Cypress, CA (733349)

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 Contractor develops 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. 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 Hospital, Physician, Pharmacy, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties.

Primary Responsibilities:

  • 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
     

Required Qualifications:

  • Undergraduate degree or equivalent experience
  • 3+ years of experience in a network management-related role, such as contracting or provider services.
  • In-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)
  • 2+ years of experience in fee schedule development using actuarial models
  • 2+ years of experience utilizing financial models and analysis in negotiating rates with providers
  • At least an intermediate level of knowledge of claims processing systems and guidelines
  • 2+ years of experience in performing network adequacy analysis

Preferred Qualifications:

  • 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

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can 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.

 

Job Keywords: Healthcare, Managed Care, Hospital Contracting, Physician Contracting, Ancillary Contracting, Facility Contracting, Provider Network, Network Development, Provider Services, Contract Negotiating, Network Management, Accountable Care Organization (ACO), Cypress, CA, California

Job Details

  • Contest Number733349
  • Job TitleHealthcare Provider Network Contractor - Cypress, CA
  • Job FamilyNetwork Contracting and Pricing
  • Business SegmentUnitedHealthcare Networks

Job Location Information

  • Cypress, CA
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelYes, 25 % of the Time
  • Telecommuter PositionNo
  • 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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