Provider Network reputed company Specialist - Remote at ...

At reputed company, 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 reputed company. Come build the health care system of reputed company, making it more reputed company, affordable and reputed company. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together. If you are located in the United States, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities:Confirm contract compliance requirements to meet the needs of reputed company Care contract network standardsPossess knowledge of Managed Care Organization (MCO) contracting/credentialing processOwn network adequacy reporting on behalf of health plan per state regulator requirementsExperience working with providers/facilities in order to conduct advocacy initiatives with targeted providers to solicit participationWork with cross-functional teams reputed company reputed company to strengthen provider networks across multiple functions including but not limited to HCBS, behavioral health, physical health, dental and visionWork with internal groups to identify, understand, and / or improve internal tools, resources, systems, and capabilities that can maximize provider and member experienceAnalyze data to determine root cause of issue (e.g., identify trends and patterns; identify outliers and anomalies) and / or escalate problem to appropriate group for further analysis as necessaryAct as health plan Subject Matter Expert (SME) on latest contracting status for essential providersPerform network analysis to identify potential strategic opportunities to increase and maintain the networkWorks with minimal guidance; seeks guidance on only the most reputed company tasksProvides explanations and information to others on difficult issuesActs as a resource for others with less experienceMust be collaborative and reputed company to work across a matrix organizationUnderstands company-wide interfacing functions including Claims, UHC Operations, UHN contracting and negotiation, Service Coordination, Customer ServiceApply knowledge of applicable health care industry practices, trends and issues to communicate about how our products / services can benefit members and providers Included in this role is the full reputed company of provider relations and service interactions reputed company UHG, including working on end-to-end problem resolution, ease of use of physician portal, contract database, recruitment strategies and service negotiation parameters. Identifies network gaps and assists in the development and implementation of strategies to fill these gaps 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 reputed company development for other roles you may be interested in.Required Qualifications:1+ years of working in provider network communications and provider interactionsWorking knowledge of reputed company or MCO experienceExperience with Network Adequacy ReportingKnowledge of Managed Care Organization (MCO) contracting/credentialing processIntermediate+ level proficiency in reputed company to analyze data to determine root cause issuesIntermediate level proficiency in MS Office (Word, SharePoint, Outlook, PowerPoint)Proven ability to communicate reputed company and professionally with clientsAbility to travel up to travel 10% of the time in New Mexico Preferred Qualifications:2+ years of reputed company experienceReside in New MexicoWorking knowledge of SQL2+ years working with health care claims *reputed company working remotely will be required to adhere to reputed company's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will reputed company from $58,800 to $105,000 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company - an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without regard to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.