Sr. Network Account Manager – Remote in FL (Alachua, Marton, Lake and Surrounding Counties)

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.  

 

In this role you will be expected to:

• Apply basic knowledge of provider network functions, ability to work in a fast-paced environment
• Intermediate skill level in Microsoft programs (Teams, Outlook, Word, Excel, PowerPoint) and spreadsheet management.  Microsoft Access knowledge is a plus
• 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 Long-Term Care (Home and Community Based) programs
• Must have good communication skills; and the ability to build and retain relationships with Provider/Ancillary providers
• Experience working with Health Plan contracts in compliance with company contract templates to ensure the network composition includes an appropriate distribution of provider specialties
• Display professional work ethics in a structured work environment
• Team environment aptitude, work in partnership with Sr Provider Relations Advocates and interact well with staff in cross-segment departments
• Perform other duties as required

 

If you are located in the following counties, you will have the flexibility to work remotely* as you take on some tough challenges: Alachua (Gainesville area), Putnam, Marion (Ocala area), Lake (The Villages area), Sumter, Hernando, Citrus, Levy, Dixie, Gilchrist, Lafayette, Suwanee, Hamilton, Columbia, Union, Bradford.

 

Primary Responsibilities:

• The Sr Network Account Manager services the Florida SMMC business (Medicaid/Long-Term Care)
• SR PRAs develop and maintain the provider network (ancillary groups and home and community-based service providers), yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management and produces an
• affordable and predictable product for customers and business partners
• SR PRAs evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls.
• Responsibilities also include establishing and maintaining solid business relationships with providers, and ensuring the network composition includes an appropriate distribution of Long-Term Care (LTC), Home & Community Based (HCBS) specialties

 

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:

• 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)

 

Preferred Qualifications: 

• Associate’s Degree
• Ability to work in a fast-pace ever-changing environment
• Proven solid interpersonal skills, establishing rapport and working well with others.
• Proven solid customer service skills 
• Bilingual in English/Spanish 

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

 

The salary range for this role is $71,600 to $140,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe 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 experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.  

 

 

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.  

 

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.