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About UHG

Careers at UnitedHealth Group

 

We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Network Contracting and Pricing

Country:

US

Approximate Salary:

Not Specified

Position Type:

Full Time

Provider Network Contracting Specialist (LHI) – La Crosse, WI; Eau Clair, WI and Tampa, FL

UHG - Eau Claire, Wisconsin

Posted: 12/12/2018

At Optum, the mission is clear:  Help people live heathier lives and help make the health system work better for everyone

 

LHI is one of 4 businesses under OptumServe. OptumServe provides health care services and proven expertise to help federal government agencies modernize the U.S. health system and improve the health and well-being of Americans.

 

By joining OptumServe you are part of the family of companies that make UnitedHealth Group a leader across most major segments in the U.S. health care system.

 

LHI was founded in 1999 and acquired by Optum in 2011, LHI specializes in creating and managing health care programs through on-location services, patient-specific in-clinic appointments, telehealth assessments, or any combination based on customer need. LHI's customizable solutions serve the diverse needs of commercial customers, as well as federal and state agencies, including the U.S. Departments of Defense, Veterans Affairs, and Health and Human Services.

 

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Ready for a new path? Start doing your life's best work.

 

The Provider Network Contracting Specialist (LHI) – La Crosse, WI,  Eau Clair, WI and Tampa, FL will build and maintain a successful working relationship between LHI and network providers to ensure a geographically competitive, broad access and stable network. Routinely negotiate cost effective fees, confirm service capability, respond to provider inquiries, and educate providers on contract expectations, processes and paperwork.  Support implementation of strategies relating to the development and management of the provider network. Comprehend detailed knowledge of contracts in order to translate subcontractor and fee agreements to the providers. Must be able to routinely evaluate and negotiate contracts in compliance with company contract templates, reimbursement standards, and other key process controls, while maintaining network composition that includes an appropriate distribution of provider specialties. 

 

Primary Responsibilities:

  • Recruit and contract providers according to LHI and department policy
  • Must understand contracts between LHI and LHI customers and how this translates to the subcontractor agreement and fee arrangements between LHI and all providers
  • Negotiate contracts and fees that align provider needs and LHI business objectives
  • Educate providers on fee structures to ensure collaborative agreement and understanding of LHI Services and the fees associated with them
  • Initiate appropriate credentialing processes and workflows
  • Assess and resolve specific provider concerns, developing and implementing solutions that are beneficial to providers, LHI Customers and LHI
  • Provide explanations and information to others on topics within area of expertise
  • Manually assign qualified providers to orders within the contractually allowed mileage radius

Required Qualifications:

  • High School Diploma / GED (or higher)
  • 2+ plus years of experience with either healthcare provider relations, network management, or negotiations specific to hospitals, physicians, pharmacies, ancillary groups and/or other related medical provider relations
  • 2+ years experience negotiating rates and managing subcontractor relationships (ie: contracts for primary care and specialty practices)
  • Proficient experience with Microsoft Excel (general spreadsheet navigation, sorting and data input), Word (creating and editing documents) and Outlook (calendar and email)
  • May require occasional travel up to 3 times a year

Preferred Qualifications:

  • Bachelor’s Degree (or higher) in Business, Marketing and Communications or healthcare related field
  • 2+ years of experience with provider relations, network management, customer service or negotiations
  • Working knowledge of general contracting terms and concepts such as: privacy and confidentiality, indemnification, insurance, non-disclosure, and remedies and dispute resolution
  • Experience with structured practices of contract modification, including discussion of terms and coordination of changes through management and attorneys
  • Medical Support Los Angeles (MSLA) experience
  • Medical, dental, or healthcare insurance experience
  • Basic knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)

Soft Skills:

  • Ability to influence and negotiate through use of verbal, written and interpersonal means with a diverse group of people / disciplines at all levels of an organization
  • Excellent verbal, written and interpersonal skills
  • Ability to work independently in a fast-paced environment, flexible and adaptable to changing situations
  • Ability to demonstrate an appropriate level of assertiveness in performing work responsibilities and in making work related decisions
  • Strong customer service skills
  • The ability to speak clearly and concisely while conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others

Careers with LHI. Our focus is simple. We’re innovators in cost-effective health care management. And when you join our team, you’ll be a partner in impacting the lives of our customers, and employees. We’ve joined OptumHealth, part of the UnitedHealth Group family of companies, and our mission is to help the health system work better for everyone. We’re located on the banks of the beautiful Mississippi River in La Crosse, Wis., with a satellite office in Chicago and remote employees throughout the United States. We’re supported by a national network of more than 25,000 medical and dental providers. Simply put, together we work toward a healthier tomorrow for everyone. Our team members are selected for their dedication and mission-driven focus. For you, that means one incredible team and a singular 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.


Keywords: healthcare provider relations, network management, negotiations, negotiate, hospitals, physicians, pharmacies, ancillary groups, medical provider relations, LHI, Logistics Health, La Crosse, WI, Eau Clair, WI

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