1+ months

Credentialing Representative - Concord, CA - 876854

Concord, CA 94519
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  • Job Code
    876854

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doingyour life's best work.(sm)


TheCredentialing Representativeassists in the design and implementation programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Other responsibilities include working on end-to-end provider claim and call quality, ease of use of physician portal and future service enhancements, training & development of external provider education programs, supporting those who direct and implement strategies relating to the development and management of a provider network, identify gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs, and may also be involved in identifying and remediating operational short-falls and researching and remediating claims.


Primary Responsibilities:

  • Apply knowledge / skills to a range of moderately complex activities

  • Demonstrate great depth of knowledge / skills in own function

  • Sometimes act as a technical resource to others in own function

  • Proactively identify solutions to non - standard requests

  • Solve moderately complex problems on own

  • Work with team to solve complex problems

  • Plan, prioritize, organize and complete work to meet established objectives

  • May coordinate work of other team members

  • Extensive work experience within own function

  • Work is frequently completed without established procedures

  • Works independently

  • May act as a resource for others

  • May coordinate others activities

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.

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Required Qualifications:

  • High School Diploma or GED

  • 4+ years of experience with health care provider credentialing

  • 2+ years of experience working with compliance workflows and processes, including NCQA policies and practices

  • 2+ years of experience in researching and applying government regulatory information

Careers at UnitedHealthcare Employer & Individual.We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This isyour life's best work.(sm)


What we do defines who we are. Take a deeper look at how we're providing support during this global health crisis and search for a way you can get involved. View our Covid-19 Resources Page: https://info.uhg.com/



Diversity creates a healthier atmosphere:UnitedHealth Groupis 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 Groupis a drug - free workplace. Candidates are required to pass a drug test before beginning employment.


Keywords: UHG, Concord, CA, Credentialing, Representative, UnitedHealth

Posted: 2020-10-27 Expires: 2020-12-26

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Credentialing Representative - Concord, CA - 876854

UnitedHealth Group
Concord, CA 94519

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