Healthcare Provider Network Specialist

4 weeks ago


Honolulu, Hawaii, United States UnitedHealthcare Full time
Transforming Healthcare with UnitedHealthcare

At UnitedHealthcare, we're revolutionizing the healthcare experience, creating healthier communities, and removing barriers to quality care. Our mission is to help people live healthier lives and make the health system work better for everyone.

Key Responsibilities:
  • Manage unit cost budgets, target setting, performance reporting, and associated financial models
  • Predict emerging customer needs and develop innovative solutions to meet them
  • Help develop geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management
  • 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
Requirements:
  • 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 analysis to negotiate rates with providers
  • 2+ years of experience in performing network adequacy analysis
  • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
  • Intermediate level of knowledge of claims processing systems and guidelines
What We Offer:

As a member of our network contracting team, you'll have the opportunity to work with a Fortune 6 leader and make a meaningful impact on the lives of millions of people. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role.

We offer a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution. Our commitment to diversity and inclusion creates a healthier atmosphere, and we're an Equal Employment Opportunity/Affirmative Action employer.



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