Network Contractor - Phoenix, AZ

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. Primary Responsibilities:

Use pertinent data and facts to identify and solve a range of problems within area of expertise
Investigate non-standard requests and problems, with some assistance from others
Work exclusively within a specific knowledge area
Prioritize and organize own work to meet deadlines
Provide explanations and information to others on topics within area of expertise
Office-based position in Phoenix, Arizona. Flexibility for some telecommuting. Need for solid experience and comprehension of provider contract language, production systems and negotiation skill set

Required Qualifications:

Undergraduate degree or equivalent combination of education and relevant experience
3+ years experience in a network management-related role, such as contracting or provider services
In-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)
Requires solid experience and comprehension of provider contract language, production systems and negotiation skill set
2+ years of experience in fee schedule development using actuarial models
2+ years of experience utilizing financial models and analysis in negotiating rates with providers
Working knowledge of claims processing systems and guidelines
2+ years of experience in performing network adequacy analysis
Excellent 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
Strong interpersonal skills, establishing rapport and working well with others
Strong customer service skills
 
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 14 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: 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, contractor, RBRVS, claims, Phoenix, AZ, Arizona