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Network Contractor - Maryland Heights, MO
| Hours | Full-time, Part-time |
|---|---|
| Location | Maryland Heights, MO Maryland Heights, Missouri |
About this job
Position Description:
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)
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 physician providers, and ensuring the network composition
includes an appropriate distribution of provider specialties.
Primary Responsibilities:
- Assess and
interpret customer needs and requirements. - Identify
solutions to non-standard requests and problems. - Solve moderately
complex problems and/or conduct moderately complex analyses. - Work with minimal
guidance; seek guidance on only the most complex tasks. - Translate
concepts into practice. - Provide
explanations and information to others on difficult issues. - Coach, provide
feedback, and guide others. - Act as a resource
for others with less experience. - Be able to handle
a fast paced work environment.
Requirements
- Bachelor's Degree or High School Diploma/GED with 2+ years of experience in a network management-related role, such as contracting or provider services.
- 2+ years experience in a network management-related role, such as contracting or provider services.
- Knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS).
- Knowledge of financial models and analysis in negotiating rates with providers.
- 2+ years of experience with claims processing systems and guidelines.
- Verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information form others.
- Interpersonal and Customer Service skills, establishing rapport and working well with others.
Preferred Qualifications:
- Project Management experience.
Diversity creates a healthier atmosphere: 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.