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 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 6 leader.
This Provider Contracts Administrator role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. We're building better, more effective provider networks every day. In this role, you'll be responsible for negotiating, implementing, maintaining, and amending provider contracts for new and existing providers. You will monitor the network to ensure appropriate provider coverage is available for enrollees. You will function as a liaison between Provider Contracts and other internal departments to determine the ongoing provider contracting and operational issues that may warrant resolution.
- Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards, and other key process controls
- Initiate first contact with providers that are joining the network to establish a relationship and begin building a rapport by visiting the provider in a face-to-face meeting where contract overview takes place prior to Agreement being fully executed
- Support and manage contract databases
- Responsible for contract file maintenance and circulating completed agreements/amendments for signature
- Act as department liaison for audits and special projects
- Own assigned geographic area to ensure appropriate coverage for membership is available
- Prepare for and manage provider meetings, assist in marketing functions, business development, and in services as needed
- Participate in additional projects, as needed
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)
- High school diploma/GED
- 4+ years of professional work experience working with provider network contracts in the healthcare industry
- Experience negotiating contract terms and pricing
- Analytical skills to request needed reports in order to manage the contract negotiations, resolve claims issues and or have a clear understanding of the overall business structure
- Proficiency in Microsoft Office applications, including Word, Excel, and Outlook
- Strong organizational skills
- Bachelor's degree
- Experience with capitated provider network agreements
- Experience working in a fast-paced environment, ability to prioritize several projects simultaneously
- Effective communication, presentation skills, and industry knowledge
- Basic math skills
- Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists
What's the first thing that happens when one of the most successful physician groups in Orange County comes together with a global leader in health care? Opportunity. With Monarch HealthCare joining OptumCare and the UnitedHealth Group family of companies, people like you will find increasing levels of challenge, impact and professional success. With a vibrant network of hospitals and urgent care centers, we're changing health care for the better by improving access to affordable, high quality care, and working together to improve the patient experience. That takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment. Are you with us? Learn more about this exciting opportunity to do your life's best work.(sm)
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: Provider Contracts Administrator, Network Contracting, Monarch, Irvine, CA, California