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Provider Contracts Administrator - Irvine, CA

UnitedHealth Group

Irvine, CA
Job Code:
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Job Details

751327 Provider Contracts Administrator Irvine CA

Provider Contracts Administrator - Irvine, CA (751327)

Position Description

The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This Provider Contracts Administrator role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. We're building better, more effective provider networks every day. In this role, you'll use your strong customer service orientation and knowledge of insurance claims to serve as an advocate for providers in our networks. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 6 leader.
Responsible for negotiating, implementing, maintaining, and amending provider contracts for new and existing providers.  Monitors the network to ensure appropriate provider coverage is available for enrollees.  Will function as a liaison between Provider Contracts and other internal departments to determine the on - going provider contracting and operational issues that may warrant resolution.
Primary Responsibilities:
  • Responsible for initiating first contact with providers that are joining the network to establish a relationship and begin building a rapport by visiting the provider in a face - to - face meeting where contract overview takes place prior to Agreement being fully executed
  • Must exhibit strong customer service skills for continuity of maintaining / building the relationships with new / existing providers, internal customers and within the department; this includes positive communication via face - to - face meetings, over the phone and or via e - mail
  • Take ownership of assigned geographic area within the county(ies) to ensure appropriate coverage for membership is available at all times
  • When appropriate, assist in marketing functions, business development, and in services as needed.  Attend various company meetings and other provider meetings as needed.  Attend off site meetings, including meetings that are scheduled in the evening
  • Utilize the appropriate resources within the organization to establish an efficient work flow for the review, negotiation, re - negotiation and complete provider contract proposals including rates, various payment methodologies, correct scope of services for new / existing providers and to ensure that ongoing rate structures are competitive within the marketplace and appropriate
  • Function as a liaison between the Provider Contracting Department and other internal departments to determine services that need to be contracted, identify provider contracts that need to be modified due to operational issues or require contract language interpretation / intent of payment methodologies
  • Must have strong analytical skills from a financial perspective to request appropriate reports needed in order to manage the contract negotiations, resolve claims issues and or have a clear understanding of the overall business structure
  • Strong technical capabilities to understand and work in the various utilities required to use on a day - to - day basis
  • Self - motivated and extremely organized to prioritize and manage all the various tasks, projects, questions and daily issues that may occur
Required Qualifications:
  • Bachelor’s degree (BA) from four year college or university or 4+ years related experience and / or training or equivalent combination of education and experience
  • Ability to read and analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations
  • Ability to generate / write / request reports, business correspondence, and procedure manuals
  • Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public
  • Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals
  • Ability to compute rate, ratio, and percent and to draw and interpret bar graphs
  • Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists
  • Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form
What's the first thing that happens when one of the most successful physician groups in Orange County comes together with a global leader in health care? Opportunity. With Monarch HealthCare joining OptumCare and the UnitedHealth Group family of companies, people like you will find increasing levels of challenge, impact and professional success. With a vibrant network of hospitals and urgent care centers, we're changing health care for the better by improving access to affordable, high quality care, and working together to improve the patient experience. That takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment. Are you with us? Learn more about this exciting 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: provider relations, contracts, healthcare, Irvine, CA, California

Job Details

  • Contest Number751327
  • Job TitleProvider Contracts Administrator - Irvine, CA
  • Job FamilyNetwork Management
  • Business SegmentOptumCare

Job Location Information

  • Irvine, CA
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionNo
  • Overtime StatusExempt

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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