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.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 contracting experience preferably in a healthcare settingBasic level of proficiency with Microsoft Word, Microsoft Excel, and Microsoft OutlookPreferred Qualifications: Basic knowledge of provider network development and maintenance Basic knowledge of NCQA credentialing and re-credentialing standardsKnowledge of ICD-10 and CPT codesBasic level knowledge of report writing applicationsKnowledge of Crystal ReportsBasic knowledge of mapping software for network adequacy such as Quest or Ingenix GeoAccess / GeoNetworks reporting toolsBasic level of proficiency with Microsoft PowerPoint and Microsoft SharePointSoft Skills: Ability to communicate with all levels of colleagues including Senior Management and LegalCareers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is 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.Keyworks: Contracting, providers, neworks, service agreement, UnitedHealth Group, UnitedHealth Care
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.