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Network Development Specialist - Los Angeles, CA or San Bernardino, CA

UnitedHealth Group


Location:
Los Angeles, CA
Date:
02/16/2018
2018-02-162018-03-17
Job Code:
748542
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Job Details

748542 Network Development Specialist March Vision Care Los Angeles CA

Network Development Specialist - Los Angeles, CA or San Bernardino, CA (748542)

Position Description

Position Description:

 

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.


The Network Development Specialist is responsible for contracting with providers on a statewide basis including the distribution and processing of contracts for signature, ensuring all documentation is received and valid and responding timely to internal and external inquiries. This position is also responsible for following all department and company policies; proactively and reactively seeking appropriate solutions to existing issues; fully accountable for maintaining positive working relationships with external and internal customers.

Primary Responsibilities:

  • Performs assigned tasks to recruit and implement new provider networks and to maintain necessary network access levels in accordance with internal and external performance standards. These tasks include, but are not limited to;

  • Provider Network Recruiting, including cold-calls to non-par providers. (all telephonic)

  • Establishing and maintaining strong provider network relationships, in partnership with the Provider Relations team.

  • Provider contracting calls to negotiate terms of contracts and advise on reimbursement rates and contract details.

  • Engaging with internal and external stakeholders to manage and ensure provider contract compliance and integrity, including working closely with a team of network analysts, provider data coordinators, and credentialing resources.  

  • Communicates contract terms, reimbursement rates and benefits to provider community clearly and professionally.

  • Initiates, generates and tracks provider service agreements, amendments or letters of intent from initial draft to full execution.

  • Coordinates preparation and routing of documents to complete the contracting process in a timely and thorough manner.

  • Manages and ensures executed contracts are administered timely and accurately within MARCH Vision Care.

  • Follows and supports the guidelines set by the department and organization to ensure overall goals are met.

  • Supports network adequacy analysis as necessary to ensure assigned geographic areas meet client, state and / or federal requirements for network access.

  • Maintains minimum department production and quality standards.

  • Perform any other assigned duties as required by company.

Required Qualifications:
  • High School Diploma / GED (or higher)
  • 1+ years of experience working in a Provider Relations, Provider Network Development, or Network Contracting role
  • Basic knowledge of provider network development and maintenance
  • Basic level of proficiency with Microsoft PowerPoint (ability to create presentations) and Microsoft SharePoint (document management capabilities)
Preferred Qualifications:
  • Bachelor's Degree (or higher)
  • Basic knowledge of NCQA credentialing and re-credentialing standards
  • Knowledge of ICD-10 and CPT Codes
  • Basic level knowledge of report writing applications
  • Basic knowledge of mapping software for network adequacy such as Quest or Ingenix
  • GeoAccess / GeoNetwork reporting tools
  • Knowledge of Crystal Reports
Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of healthcare. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life’s best work.

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:  Network Contracting, Provider Relations, Provider Network Development, Los Angeles, CA, San Bernardino, CA, service agreement, UnitedHealth Group, UnitedHealth Care

Job Details

  • Contest Number748542
  • Job TitleNetwork Development Specialist - Los Angeles, CA or San Bernardino, CA
  • Job FamilyNetwork Management
  • Business SegmentEmployer and Individual

Job Location Information

  • Los Angeles, CA
    United States
    North America
  • Other LocationsSan Bernardino, CA

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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