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For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)If you are located in Louisville or Lexington Kentucky, you will have the flexibility to telecommute as you take on some tough challenges.This position is a dedicated role supporting UnitedHealthcare Community Plan of Kentucky.Primary Responsibilities:
Provide oversight of required coordination with the Department of Medicaid’s contracted Credentialing Verification Organization(s) (CVOs).
Coordinate workforce development initiatives conducted by the health plan and collaboratively with the Department of Medicaid and other contracted MCOs.
Coordinate internal work requirements between UnitedHealthcare Community Plan of Kentucky and network management to insure adequacy, affordability and accessibility of network to community plan members.
Serve as a resource and liaison for network management team regarding Medicaid regulations specific to provider reimbursement methodologies and accuracy.
Serve as a network resource to the UnitedHealthcare Community Plan of Kentucky CEO.
Advise on and support departmental plans and priorities to address business and operational challenges
Plan and organize network management team to ensure timely completion of network requirements
Other duties as assigned to support team
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.Required Qualifications:
Undergraduate degree or equivalent work experience
5+ years experience working with a managed care organization or health insurer; or as a consultant in a network/contract management role, such as contracting, provider services, etc. preferably in Medicaid
Understanding of and experience with facility/ancillary and physician contract reimbursement methodologies specific to Kentucky Medicaid
3+ years experience with contract submission, validation and maintenance with strong knowledge of business processes
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 7 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that’s second to none. This is no small opportunity. It's where you can do your life's best work.(sm)All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter PolicyDiversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.Job Keywords: Provider Network Director, Medicaid, contracting, provider services, Louisville, KY, Kentucky, Telecommute, Telecommuter, Telecommuting, Remote, Work from home, Work at home
