UnitedHealth Group Hiring for Recruiter, Provider Contracting Services Full Time

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life’s best work.SM

This is a critical position within the Provider Services Department and a required position within our contract budget. This is a budgeted position that is funded by the ASO contract with the County of San Diego. The position is critical to maintaining the Fee for Service and TERM Provider Networks that we manage on behalf of the County. This position will be responsible for increasing the development of the provider networks through recruitment and relationship building.

The Recruiter, Provider Contracting Services position is responsible for a full range of provider relations and service interactions. Works with Director of Behavioral Health Network and Manager of Provider Services on identifying network gaps, needs and recruitment strategies. Identifies and executes processes needed to recruit applicants. Will work with Provider Network Department staff to align recruitment and retention efforts. Maintains and ensures the integrity of provider databases; responds to provider inquiries and provides exceptional customer service to providers, County partners, peers, staff in other departments and the public. The Provider Recruiter and Relations Representative may work with providers on the TERM, and/or Medi-Cal Fee-For-Service (FFS) Network(s) as well as Off Panel, Out of Network providers, Skilled Nursing Facilities, Hospitals, which includes the San Diego County Psychiatric Hospital and/or Edgemoor Hospital, as well as other medical professionals.

Primary Responsibilities:

• Accountable for a full range of provider relations including engagement with and development of prospective providers
• Design and implement recruitment/retention strategies to increase the membership of providers in the network and retaining current providers
• Create and execute a marketing plan to build and nurture provider network
• Identify needs in provider network, incorporating potential gaps related to composition, services, geographical needs, provider demographics, or clinical specialties
• Identifying and outreaching out-of-network/off-panel providers to enter into Letter of Agreements (LOAs) for therapy and evaluation services as needed
• Support leadership in establishing and maintaining strong business relationships with Hospitals, Physicians, Pharmacies and Ancillary providers, and ensure the network composition includes an appropriate distribution of provider specialties
• Update and present Provider Recruitment s for Fee for Service and TERM provider networks
• Identify, coordinate and participate in outreach events to educate community providers on the benefit of network membership
• Establish recruiting requirements by studying organization plans and objectives and meeting with managers to discuss needs
• Build applicant sources by researching and contacting community services, professional associations, colleges, employment agencies, recruiters, media, and internet sites and provide organization information, opportunities, and benefits while making presentations and maintaining rapport
• Attract applicants by placing job advertisements, distributing/advertising provider recruitment flyers, contacting recruiters, using newsgroups or job sites
• Improve organization attractiveness by recommending new policies and practices, monitoring job offers and compensation practices, and emphasizing benefits and perks
• Update job knowledge by participating in educational opportunities, reading professional publications, maintaining personal networks, and participating in professional organizations
• Must possess the following skills: Phone and Interviewing Skills, Recruiting, People Skills, Strong decision-making, Professionalism, Good Judgment, Organizational Skills, Project Management
• Support Diversity, Knowledge on Employment Law, Focus on Results
• Assume additional responsibilities as assigned

Additional Responsibilities May Include:

• Complete administrative processes related to the application, credentialing, contacting and re-credentialing of providers
• Review all provider applications and documents to ensure compliance with the credentialing criteria for inclusion in the different networks
• Track credentialing process and send provider the completed contract once process is complete
• Run s from provider databases to track credentialing and re-credentialing activities for a variety of provider types
• Return the signed fully executed contract to new providers in the Fee For Service and TERM networks
• Track providers’ malpractice insurance, DEA, and licensure renewals to ensure they are current/active
• Track providers’ required certifications including CANS certification to ensure they are current/active and proof of active certifications are on-file
• Facilitate the resolution of credentialing issues
• Coordinate and complete external and internal termination notification requirements
• Periodically review state and federal bulletins for provider sanctions and review provider disbarment s notifying Manager of outcome
• Attend and participate in meetings to achieve departmental and interdepartmental goals and objectives
• Triage provider related issues and escalate complex problems when necessary to Manager
• Respond to claim issues by assessing fee schedule and contract configuration, procedure and diagnosis code questions, review modifiers and other claim form components in order to determine payment accuracy
• Organize provider files so they may be easily reviewed by staff, credentialing committee and external review bodies
• Accurately enter and maintain Provider data in multiple databases to be used for directories, payments, mailing labels and s
• Document communication with providers in designated databases; assist in managing the integrity of databases by using contacts with providers to verify and update provider files

What are the reasons to consider working for UnitedHealth Group? Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
• More information can be downloaded at: http://uhg.hr/uhgbenefits

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 Diploma/GED (or higher) OR 2+ years of provider network recruitment experience
• 1+ year of provider network recruitment experience
• 1+ year of provider network experience with Credentialing and re-credentialing, and provider demographics or clinical specialties
• Valid Driver’s License in the State of California
• Intermediate level of proficiency with Microsoft; Excel, Outlook, PowerPoint, OneNote, Publisher, and Word
• Ability to be granted and maintain access to the County of San Diego’s electronic health record, Cerner Community Behavioral Health (CCBH)
• Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation.

Preferred Qualifications:

• Associates Degree and/or Bachelor’s Degree
• Previous experience in managed care credentialing and/or network recruitment
• Data entry experience
• Experience working in an environment that requires coordination of benefits and working with multiple groups and resources

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

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.

Diversity 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

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