Provider Network Contract Specialist, Behavioral Health - Latham / Albany, New York
About the Job
You get it. Everyone gets it. The health care system needs to evolve even further than it has and it has to do so quickly. New models of care and new networks of providers are emerging now to better serve patients and communities. And leaders like UnitedHealth Group / Optum Behavioral Health are playing a lead role. Here's where you come in. As member of our network contracting team, you'll help develop and support Provider Networks. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 5 leader.
If you are located in Latham or Albany, NY you will have the flexibility to telecommute* as you take on some tough challenges
- Help develop geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management
- Manage unit cost budgets, target setting, performance reporting and associated financial models
- Predict emerging customer needs and develop innovative solutions to meet them
- 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.
3+ years of experience in a network management-related role, such as contracting or provider services
2+ years of experience in fee schedule development using actuarial models
2+ years of experience using financial models and/or analysis to negotiate rates with providers
Contract negotiation skills
Knowledge of claims processing systems and guidelines
Experience in performing network adequacy analysis
Behavioral Health Experience
SalesForce & document management knowledge
3+ years of experience with contract & fee schedule negotiation
Experienced in Network development & provider engagement starting with credentialing to contracted provider
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)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy
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, account management, Behavioral health, NY, MCD, Latham, Albany, New York, Telecommute, Telecommuter, Telecommuting