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Provider Service Representative - March Vision Care - Los Angeles, CA

UnitedHealth Group


Location:
Los Angeles, CA
Date:
12/12/2017
2017-12-122018-01-10
Job Code:
743764
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Job Details

743764 Provider Service Representative March Vision Care Los Angeles CA

Provider Service Representative - March Vision Care - Los Angeles, CA (743764)

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 Provider Service Representative 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 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 contracting calls, provider recruiting, ensuring contract compliance and integrity.
  • 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.
  • Ensures executed contracts are administered timely and accurately within MARCH.
  • Performs precise entry of provider and vendor information to ensure accurate provider rosters and overall data integrity.
  • Follows and supports the guidelines set by the department and organization to ensure overall goals are met.
  • Performs 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 negotiating Provider contracts

  • Basic knowledge of provider network development and maintenance

Preferred Qualifications:

  • Basic knowledge of NCQA credentialing and re-credentialing standards

  • Knowledge of ICD-10 and CPT Codes

  • Basic level knowledge of report writing applications

  • Knowledge of Crystal Reports

  • Basic knowledge of mapping software for network adequacy such as Quest or Ingenix GeoAccess / GeoNetwork reporting tools

  • Basic level of proficiency with Microsoft PowerPoint and Microsoft SharePoint (with the ability to put together presentations and to maneuver through the system)

Soft Skills:

  • Ability to communicate with all levels of colleagues including Senior Management and Legal

Careers with MARCH® Vision Care. Now this is a place where you can bring your compassion and desire to innovate. MARCH® Vision Care was built with a groundbreaking platform in mind for delivering quality vision care - one that not only focuses on early disease detection, but also uses state-of-the-art technology to help improve communication between members and their doctors. As part of the UnitedHealth Group family of businesses, we specialize in the administration of vision care benefits for managed care organizations, specifically for government sponsored programs such as Medicaid, Medicare, Medicare- Medicaid Plans, and Healthcare Exchange. Join our team and you'll quickly realize this is the opportunity to do 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:  Contracting, providers, networks, service agreement, UnitedHealth Group, UnitedHealth Care

Job Details

  • Contest Number743764
  • Job TitleProvider Service Representative - March Vision Care - Los Angeles, CA
  • Job FamilyNetwork Management
  • Business SegmentEmployer and Individual

Job Location Information

  • Los Angeles, CA
    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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