14 days old

Optum Outpatient Behavioral Health Contracting - Telecommute in Western USA - 941134

Phoenix, AZ 85003 Work Remotely
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  • Job Code
    941134

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

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The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This Outpatient Behavioral Health Contracting role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. Were building better, more effective provider networks every day. In this role, youll use your strong contracting experience to build and maintain our behavioral health provider networks. As you do, youll discover the impact you want and the resources, backing and opportunities that youd expect from a Fortune 5 leader.

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If you are located in Western United States, you will have the flexibility to telecommute* as you take on some tough challenges.

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Primary Responsibilities:

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  • Telecommute position; must reside in Western United States; ideal candidate will reside in Arizona, California or Washington State
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  • Serve as the subject matter expert for Medicaid, Medicare and commercial outpatient behavioral health provider / agency / group contracting in the states you are assigned
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  • Conduct provider outreach for outpatient behavioral health provider / agency / group network expansion
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  • When interacting with providers, manage provider expectations about timelines for contracting, credentialing, reimbursement levels and methodology, site audits, and the like
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  • Assemble provider agreements consisting of base agreements, appendices and addendums, fee schedules and related documents
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  • Issue provider applications, agreements and related documents to providers
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  • Gather completed provider applications and other documents that accompany the application, other documents required by state law and/or company policy; review these documents for completeness, accuracy, organize, and submit documents for credentialing
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  • Coordinate and follow-up with Optum Provider Relations Advocates to ensure timeliness of submission of applications and related documents
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  • Actively participate in Western Region Outpatient Behavioral Health Contracting Team Meetings
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  • Understand health plan provider contracts and contract language, terms and conditions and occasionally review providers proposed language changes and occasionally draft counter language for review by supervisor and legal counsel)
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  • Report to the Director of Outpatient Behavioral Health Contracting of the Western US
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  • Keep Director of Outpatient Behavioral Health Contracting of Western US and Senior Outpatient Behavioral Health Contracting Manager Updated on timely basis about provider network development, contracting developments, rate negotiations, rate increase requests, emerging issues and the like
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  • Develop, update and maintain numerous fee schedules
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  • Actively participate in joint Provider Relations - Outpatient Behavioral Health Contracting Meetings to ensure continuity of communication and coordination between
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  • Email and phone communication with internal and external customers throughout each day
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  • Reports directly to Director of Outpatient Behavioral Health Contracting of Western US
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  • This is a salaried position and will require more than 40 hours per week at times to keep up with work or complete work assignments
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  • Team player
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Are you ready for a challenge? Youll be part of a performance driven, fast paced organization that is serving multiple markets and youll be charged with educating and building relationships with providers to evolve ongoing processes and programs.

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Youll 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:

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  • High school diploma or equivalent work experience
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  • 4+ years of health care / managed care experience
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  • 2+ years of behavioral health provider contracting experience (actually preparing, negotiating and issuing contracts to providers)
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  • 1+ years of experience with Arizona, California and/or Washington Medicaid programs and regulations, and Medicare programs and regulations
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  • Proficiency with MS Word, Excel, PowerPoint and Access
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  • Ability to learn and use proprietary and other software programs for sending, updating and storage of provider / agency / group contracts and numerous fee schedules and related contractual documents
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  • Ability to work in fast-paced work environment with multiple competing priorities and people from multiple functions within company and multiple external customers and ability to re-prioritize as work and customer deadlines and demands change throughout day and week
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  • Exceptional verbal (telephone, video conferencing and in-person) and written communication skills (emails, memos and letters)
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  • Ability to use tact and diplomacy when appropriate
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  • Ability to use superior discernment in stakeholder and provider communications
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  • Ability to communicate effectively, professionally and comfortably with staff at multiple levels and from multiple functional areas and from various professional fields within provider / agency / group organizations (e.g., CEOs, CFOs, COOs, Contract Directors, Clinical Directors, Medical Directors, Program Directors, and various types of direct service professionals)
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  • Ability to engage in light travel within the market as needed
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  • Telecommute position; live in the Western U.S.; ideal candidate will reside in Arizona, California or Washington State
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Preferred Qualifications:

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  • Undergraduate degree, preferably in business administration, public administration, healthcare administration, social services or related field. Masters degree in one of these fields a plus
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  • 3+ years of experience:""
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    • Working at a health plan / managed care organization contracting with behavioral health providers, especially Medicaid outpatient behavioral health
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    • Negotiating behavioral health contracts between behavioral providers and health plans / managed care providers
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    • Medicaid provider contracting experience
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    • Working with behavioral health CPT codes
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    • Interacting with behavioral health professionals and/or behavioral health organizational leaders when working with prospective providers
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  • 2+ years of Arizona, California and/or Washington Medicaid behavioral health provider contracting experience strongly preferred - especially in behavioral health
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  • 1+ years of experience:""
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    • Proficiency using Excel to develop and analyzing behavioral health fee schedules using Excel
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  • Experience and knowledge with Arizona, California and/or Washington Medicaid health insurance and behavioral health insurance communities / markets
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  • Experience and knowledge of larger Arizona, California and/or Washington Medicaid outpatient behavioral health provider / agencies / groups communities and markets
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  • Experience and knowledge of Optum tools including but not limited to:""
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    • Saleforce
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    • OHBS FACETS
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    • DocuSign or AdobeSign
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    • ePUFs (electronic provider update forms)
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    • PLINX
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    • SURE Reports
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    • FAT (Financial Analysis Tool)
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    • Fee Schedule Pricing Profiles
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  • Arizona, California and/or Washington Medicaid, including but not limited to state agencies, programs, laws, rules and regulations, related to Medicaid
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  • Proficient with Excel, and previous experience developing, updating and maintaining provider outpatient behavioral health Medicaid fee schedules
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  • Exceptional verbal and written communications
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  • Exceptionally well-organized self-starter who is able to learn quickly and often on own, work with minimal supervision and keep up with workload
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  • Ability to interact and communicate with individuals in a variety of positions (external customers: CEOs, CFOs, COOs, Contract Directors, and others; internal customers: Contract Managers, Provider Relations Advocates, Directors, Vice Presidents, and individuals from a wide variety of functional areas)
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  • Ability to work in a very fast-paced work environment with multiple, competing priorities
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  • Ability to follow-through with assignments and tasks is a MUST with both internal and external customers
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  • Ability to keep up with heavy workload
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  • Ability to learn the position and begin performing the work quickly
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  • Ability to work with providers / agencies / groups and tell them no to various contract and reimbursement requests with respect and tact and confidence
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  • Ability to navigate complex, challenging external and internal stakeholder relationships without it interfering with ability to accomplish job duties and work directives in effective and efficient manner
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  • Treat external and internal stakeholders with dignity and respect
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  • Proven internal and external customer service skills
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  • Proven negotiation skills
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Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

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Colorado Residents Only: The salary range for Colorado residents is $53,300 to $95,100. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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, youll find a far-reaching choice of benefits and incentives.

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

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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.

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

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Job keywords: Optum Outpatient Behavioral Health Contracting, Healthcare, Managed Care, Behavioral Health, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, WAH, Phoenix, AZ, Arizona, Western USA

Posted: 2021-07-09 Expires: 2021-08-08

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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Optum Outpatient Behavioral Health Contracting - Telecommute in Western USA - 941134

UnitedHealth Group
Phoenix, AZ 85003

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