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 Associate Network Contractor ? UHC C&S ? Maitland, FL - MAITLAND, Florida, United States

   
Job information
Posted by: UnitedHealth Group 
Hiring entity type: Insurance 
Work authorization: Existing work authorization required for United States
Position type: Direct Hire, Full-Time 
Compensation: ******
Benefits: See below
Relocation: Not specified 
Position functions: Insurance
Operations - Purchasing
 
Travel: Minimal 
Accept candidates: from anywhere 
Languages: English - Fluent
 
Minimum education: See below 
Minimum years experience: See below 
Resumes accepted in: English
Cover letter: No cover letter requested
Job code: 857321 / Latpro-3723398 
Date posted: Dec-25-2019
State, Zip: Florida, 32751

Description

Here you are in the earlier stages of what could be a deeply rewarding career. You have the potential, the energy and the aspiration to take on meaningful challenges and make a difference. Now, let's talk about what you can do with our leading, global health care organization. UnitedHealth Group is playing a lead role in the formation of new, effective provider networks.

As member of our network contracting team, you'll help develop and support Provider Networks and guide unit cost management activities through financial and network pricing modeling, analysis and reporting. As you do, you'll find the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 6 leader.


Primary Responsibilities:


  • Manage unit cost budgets, target setting, performance reporting and associated financial models
  • Predict emerging customer needs and develop innovative solutions to meet them
  • Help develop geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management
  • Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls
  • Ensure that network composition includes an appropriate distribution of provider specialties


Get ready for a high impact role. You'll be tasked with working in conjunction with our national clinics and hospitals to manage, collect and analyze provider data, updating and loading provider data and resolving any escalated issues with the clients.


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. Evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Establishes and maintains strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.



Requirements

Required Qualifications: 

Onsite position in Maitland (files are housed in our office), potential to hire for the Tampa location but not preferred due to location of the files.

  • Associate degree or equivalent work experience

  • Minimum of 2 years or more working in provider networks/Medicaid, preferably Long Term Care but can be trained 

  • Must have good business skills with excellent attention to detail

  • 3 years or more of provider network experience to include processing contract documents, reviewing credentialing files, provider relations

  • Mid to advanced level Microsoft Excel, PowerPoint, Word – and Access knowledge is helpful (this position will also be responsible for our network reporting

  • Bilingual EnglishSpanish due to servicing our providers in region 11

  • Looking for someone who has a team spirit, a drive for success, and eager to learn and grow with the company

 

Please note, there is flexibility with the requirements as this position does have opportunity for training and growth.

 

Preferred Qualifications:

  • Undergraduate degree

  • Experience working with UHC C&S


Creating and fine tuning provider networks helps improve access to health care for millions. It's an outstanding opportunity to have more meaning and purpose in your career. Join us. Find out how you can start doing your life's best work.(sm)

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and highrisk pregnancy. Our holistic, outcomesbased approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)


For more information on our Internal Job Posting Policy, click here.


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.   



 

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