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Network Contract Specialist - San Antonio, TX

UnitedHealth Group


Location:
San Antonio, TX
Date:
11/23/2017
2017-11-232017-12-22
Job Code:
732118
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Job Details

732118 Network Contract Specialist San Antonio TX

Network Contract Specialist - San Antonio, TX (732118)

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 Contract Specialist is responsible for managing administrative tasks aligned with the contracting process, as well as providing internal support to Network Contractors. The Network Contract Specialist will create contracts, validate data including provider demographic information and submit load requests to the appropriate internal team. They will also be a key resource to Network Contractors, addressing questions regarding contract language, contract set-up, payment methodology and other processes. Attention to detail, problem solving, and establishing and maintaining strong business relationships are crucial for success in this role.

 

Primary Responsibilities:

  • Communicating contractual terms with providers

  • Negotiating mutually acceptable agreements

  • Understanding of contract policies to ensure compliance and consistent contracting across the enterprise

  • Ensuring the network adequacy requirements are met for each provider specialty

 

 

Required Qualifications:

  • Undergraduate degree or related experience

  • 3+ years’ experience in a network management-related role, such as contracting or provider services

  • 2+ years of experience utilizing financial models and analysis in negotiating rates with providers

  • 2+ years of experience in performing network adequacy analysis

  • Familiarity with fee schedule development using actuarial models

  • At least an intermediate level of knowledge of claims processing systems and guidelines

  • At least an intermediate proficiency with MS Office suite including Word and Excel

Preferred Qualifications:

  • In-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)

  • 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 WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 90,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team 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.

 

 

Job Keywords: Network Contract Specialist, network management, contracting, provider services, analysis, San Antonio, TX, Texas

 

Job Details

  • Contest Number732118
  • Job TitleNetwork Contract Specialist - San Antonio, TX
  • Job FamilyNetwork Contracting and Pricing
  • Business SegmentOptumCare

Job Location Information

  • San Antonio, TX
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelNo
  • 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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