Provider Services Specialist - Hudson Valley, NY Job in Kingston 12401, New York US

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.UnitedHealthcare is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.   When you work with UnitedHealthcare, what you do matters. It's that simple…and it's that challenging.   In providing consumer-oriented health benefit plans to millions of people, our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system.   UnitedHealthcare, a UnitedHealth Group company, provides network-based health and well-being benefits and services for employers and consumers nationwide. We use our strength, diversity and innovation to improve the lives of the more than 18 million people who receive our unique products and services. And our endless pursuit for excellence in everything we do extends to your career as well. Join us today for an inspired and purposeful mix of professional growth opportunities and personal rewards.   Physician, Provider Service Specialist   This is a great opportunity to work from our Kingston office, or telecommute from your home in the Hudson Valley area 2 - 3 days a week, with the remaining time "on the road" in the territory, which consists of the seven county Hudson Valley region.  We are looking for a self-motivated individual with strong interpersonal skills and experience as in a Provider Services role to help us grow the territory.   In this role, you will be accountable for:  Physician network development and management activities in accordance with UnitedHealthcare standards and key process controls to achieve market/region/division/company objectives, including implementing network strategy and negotiating rates for physiciansPhysician contract negotiationsContribute to development of and successfully perform to geographic-specific unit cost targetsMonitor respective geographic-specific unit cost performance and improve competitiveness, breadth, and stability of Physician networkSuccessfully implement geographic-specific unit cost improvement plans for Physician networkFill Physician network gaps at geographic-specific competitive rates in accordance with unit cost targetsEnsure integrity of Physician network with UnitedHealthcare policies and compliance with pertinent regulatory guidelinesAccountable for relevant components of provider relationship management, including provider outreach/communicationPromote use of electronic provider on-line self-service tools in order to support and achieve operational efficiencyMonitor activities related to contract load process; engage appropriate service organization for claims resolution; ARO; EDI; provider service/performance issues; and provider appealsMaintain highest personal/professional integrity and enforce Principles of Integrity and Compliance Regardless of your role at UnitedHealthcare, the support you feel all around you will enable you to do what you do with energy, integrity, and confidence. So take the first step in what is sure to be a fast paced and highly diversified career.   Three to five years in a network management/contract management role, such as contracting, provider services, purchasing, etc.Bachelors degree in business, health care management, or related field or equivalent experienceDemonstrated effective contract negotiation skills and implementation/influencing skillsAbility to utilize and interpret financial models and network adequacy analysesStrong knowledge of RBRVS reimbursement methodology and clear understanding of claims processing guidelinesProblem solving skills, including the ability to systematically analyze complex problems, draw relevant conclusions, and successfully devise/implement appropriate solutions calmlyExcellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others. Proficient in speaking in both individual and group settingsAbility to multi-task, shifting back and forth effectively among multiple activitiesPossesses good interpersonal skills, establishing rapport and working well with others  Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V UnitedHealth Group is a drug-free workplace.  Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.