The Network Development Specialist is responsible for managing administrative tasks aligned with the contracting process. The Network Development Specialist will create contracts, validate data including provider demographic information and submit load requests to the appropriate internal team. They will also be responsible for addressing questions regarding contract language, contract set-up, payment methodology and other processes. Attention to detail, problem solving, and establishing and maintaining strong business relationships are crucial for success in this role.
Responsibilities also include communicating contractual terms with providers and negotiating mutually acceptable agreements, understanding of contract policies to ensure compliance and consistent contracting across the enterprise, and ensuring the network adequacy requirements are met for each provider specialty.
- Undergraduate degree or related experience
- 3+ years’ experience in a network management-related role, such as contracting or provider services
- 2+ years of experience utilizing financial models and analysis in negotiating rates with providers
- 2+ years of experience in performing network adequacy analysis
- Familiarity with fee schedule development using actuarial models
- At least an intermediate level of knowledge of claims processing systems and guidelines
- At least an intermediate proficiency with MS Office suite including Word and Excel
- In-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)
- 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
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: health care, healthcare, contracting, network management, network development, provider data, contract configuration, Medicare, WellMed, San Antonio, Texas, TX