Provider Network Access Specialist - Remote in New Mexico

UnitedHealth Group

Full-Time
Closes on Friday, May 31, 2024

Job Description

Confirm contract compliance specifics to meet the needs Turquoise Care contract network standards Work with cross-functional teams within UnitedHealthcare to strengthen provider networks across multiple functions including but not limited to behavioral health, physical health, dental and vision Conduct advocacy activities with targeted providers to solicit participation Work with internal groups to identify, understand, and / or improve internal tools, resources, systems, and capabilities that can maximize provider and member experience Analyze 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 necessary Own network adequacy reporting on behalf of health plan per state regulator requirements Act as health plan Subject Matter Expert (SME) on latest contracting status for essential providers Perform network analysis to identify potential strategic opportunities to increase and maintain the network Works with minimal guidance; seeks guidance on only the most complex tasks Provides explanations and information to others on difficult issues Acts as a resource for others with less experience Must be collaborative and able to work across a matrix organization Understands company–wide interfacing functions including UHC Operations, UHN contracting and negotiation, Service Coordination, Customer Service Apply knowledge of applicable health care industry practices, trends and issues to communicate about how our products / services can benefit members and providers

Full-Time sympOne_feae8781a6ab704acdbcc59c1c644ade UnitedHealth Group
Provider Network Access Specialist - Remote in New Mexico - 128067