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 Contractor 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. Network Contractors evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities:Use pertinent data and facts to identify and solve a range of problems within area of expertiseInvestigate non-standard requests and problems, with some assistance from othersWork exclusively within a specific knowledge areaPrioritize and organize own work to meet deadlinesProvide explanations and information to others on topics within area of expertise
Required Qualifications:Undergraduate degree or equivalent work experience3+ years of experience with claims systems3+ years of experience with contract submission, validation and maintenanceIntermediate level of proficiency with facility, ancillary and / or physician contract reimbursement methodologiesIntermediate proficiency in MS Office (Excel and PowerPoint).Strong knowledge of business processes that impact facility, physician, and/or ancillary contact loading and auditing Preferred Qualifications:Project Management experience Internal candidate must have skills with NDB, CSP, COSMOS, Mass mailing, or provider data experience Excellent communication skills required including ability to communicate effectively with various levels of leadershipMS AccessExperience in claims processing, provider data maintenance, contracting, or contract loadingCareers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can 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 Management, Contracting, Provider, Claims, RBRVS, Telecommute, Telecommuter, Telecommuting, Remote, Work from home, Pittsburgh, PA, Pennsylvania
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.