UnitedHealth Group-posted 7 months ago
$71,600 - $140,600/Yr
Full-time • Mid Level
Remote • Gainesville, FL
Insurance Carriers and Related Activities

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 equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Sr. Network Account Manager will oversee provider relation networks for Community & State Long-Term Care Divisions. This role will be responsible for provider contracting, credentialing and re-credentialing, conducting provider relations tasks, providing education, working in the provider portal and EVV (electronic visit verification), helping with claims, ensuring network adequacy and closing gaps where necessary, along with network tracking and reporting. This associate works with the case management staff to assist with network needs for member benefits and services, to include working SCAs and PNRs (Single Case Agreements and Provider Network Requests). The goals of our Long-term care network team are to manage and carry out the provider network requirements for the Health Plan with the State regulator.

  • Oversee provider relation networks for Community & State Long-Term Care Divisions.
  • Responsible for provider contracting, credentialing and re-credentialing.
  • Conduct provider relations tasks and provide education.
  • Work in the provider portal and EVV (electronic visit verification).
  • Assist with claims and ensure network adequacy.
  • Close gaps where necessary and perform network tracking and reporting.
  • Work with case management staff to assist with network needs for member benefits and services.
  • Evaluate and negotiate contracts in compliance with company contract templates.
  • Establish and maintain solid business relationships with providers.
  • High School degree.
  • 3+ years working in a network management-related role, such as contracting or provider services.
  • 2+ years of experience in ancillary/facility/group credentialing, to include knowledge of credentialing requirements for the State of Florida.
  • 2+ years working with provider/group Medicaid/Long Term Care contracts, claims, credentialing.
  • 3+ years of advanced Excel experience.
  • 2+ years of proven solid customer service skills.
  • Fluent in English.
  • Excellent verbal and written communication skills.
  • Ability to travel 25% of the time (some overnights).
  • Associate's Degree.
  • Ability to work in a fast-paced ever-changing environment.
  • Proven solid interpersonal skills, establishing rapport and working well with others.
  • Bilingual in English/Spanish.
  • Comprehensive benefits package.
  • Incentive and recognition programs.
  • Equity stock purchase.
  • 401k contribution.
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