Credentialing Specialist - Miami, FL - Bilingual Required

UnitedHealth Group•Miami, FL

6d•$29 - $52•Remote

About The Position

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together This position will be telecommute with occasional travel in Miami - 25%25 The goals of our LTC network team are to manage and carry out the provider network requirements and all functions related to credentialing and re-credentialing. Provider Relations experience is a plus, Microsoft Excel intermediate to advanced level is required due to the needs of network reporting. Microsoft Access basics is a plus. High school diploma required, prefer candidate to have Associate Degree. In this role you will be expected to: Oversee/Facilitate/Complete receipt of provider applications Oversee/Facilitate/Complete analysis and verification of provider credentials Perform other assignments as required If you are located in FL, you will have the flexibility to work remotely as you take on some tough challenges. Primary Responsibilities: Gather and process Florida State Required (AHCA) Homelike Environment Assessments (HLEs) Analyzes and Investigates Prioritizes and organizes own work to meet deadlines Provide explanations and information to others on topics within area of expertise Apply basic knowledge of provider network functions, ability to work in a fast-paced environment Intermediate skill level in Microsoft programs (Outlook, Word, Excel) and spreadsheet management Ability to take initiative and use problem-solving skills for issue resolution Depend minimally on others for instruction, guidance or direction. Must be attentive to detail, work with flexibility, and have the capability of multi-tasking to meet deadlines and deliverables Possess knowledge in Medicaid and LongTerm Care programs and services Must have good communication skills; and the ability to build and retain relationships with Physician or Ancillary providers Review and process, apply functional expertise for provider/ancillary credentialing and re-credentialing Assist with contract management to include contract loading submissions Display professional work ethics in a structured work environment Perform other duties as required 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 as well as provide development for other roles you may be interested in.

Requirements

3+ years of experience /knowledge in the Agency for Healthcare Administration Statewide Medicaid Managed Care (SMMC) Medicaid/Long Term Care business
3+ years working in a network management-related role, such as provider services, credentialing, contract processing
3+ years of experience and/or certification in ancillary credentialing, to include knowledge of credentialing requirements for the State of Florida
3+ years of experience in fee schedule management
3+ years of experience in network adequacy analysis
Proven 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
Proven intermediate level in Microsoft Word, Excel, PowerPoint, Access
Proven solid interpersonal skills, establishing rapport and working well with others
Proven solid customer service skills
Bilingual - English/Spanish

Nice To Haves

English/Spanish bilingual

Responsibilities

Gather and process Florida State Required (AHCA) Homelike Environment Assessments (HLEs)
Analyzes and Investigates
Prioritizes and organizes own work to meet deadlines
Provide explanations and information to others on topics within area of expertise
Apply basic knowledge of provider network functions, ability to work in a fast-paced environment
Intermediate skill level in Microsoft programs (Outlook, Word, Excel) and spreadsheet management
Ability to take initiative and use problem-solving skills for issue resolution
Depend minimally on others for instruction, guidance or direction. Must be attentive to detail, work with flexibility, and have the capability of multi-tasking to meet deadlines and deliverables
Possess knowledge in Medicaid and LongTerm Care programs and services
Must have good communication skills; and the ability to build and retain relationships with Physician or Ancillary providers
Review and process, apply functional expertise for provider/ancillary credentialing and re-credentialing
Assist with contract management to include contract loading submissions
Display professional work ethics in a structured work environment
Perform other duties as required