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Remote Provider Network Development Jobs in Georgia

AutomationDirect

Network Administrator

Cumming, GA · Remote

Maintain the current environment and provide daily network support for the company * Review ... remote access, network segmentation, access control, and secure connectivity between internal ...

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Remote Provider Network Development information

What are some common challenges faced by professionals in Remote Provider Network Development roles and how can they be addressed?

One of the main challenges in Remote Provider Network Development is building strong relationships with providers and stakeholders without regular face-to-face interaction. This requires effective virtual communication skills and the ability to leverage digital collaboration tools. Additionally, navigating differing regulations and provider expectations across regions can be complex, so staying organized and informed about local requirements is crucial. Proactively scheduling regular check-ins and utilizing centralized documentation can help maintain alignment and foster trust among network partners.

What is the difference between Remote Provider Network Development vs Remote Provider Relations Specialist?

AspectRemote Provider Network DevelopmentRemote Provider Relations Specialist
Primary FocusBuilding and expanding provider networks, negotiating contractsManaging existing provider relationships, resolving issues
Required CredentialsHealthcare administration, insurance, or related certificationsCustomer service, healthcare administration certifications
Work EnvironmentStrategic planning, cross-department collaborationProvider communication, issue resolution
Industry UsageHealth insurance companies, managed care organizations

Remote Provider Network Development focuses on expanding and negotiating provider networks, while Remote Provider Relations Specialists manage ongoing provider relationships and address issues. Both roles require healthcare or insurance knowledge but differ in their strategic versus operational focus.

What is a Remote Provider Network Development specialist?

A Remote Provider Network Development specialist is responsible for identifying, recruiting, and managing healthcare providers to join a health plan’s network, all while working remotely. They negotiate contracts, ensure providers meet quality standards, and maintain strong relationships to ensure network adequacy. This role often involves analyzing data to identify network gaps and collaborating with internal teams to address member needs. Remote work allows these specialists to connect with providers across various regions without needing to be on-site.

What are the key skills and qualifications needed to thrive as a Remote Provider Network Development professional, and why are they important?

To excel in Remote Provider Network Development, you need expertise in healthcare network management, contract negotiation, and provider relations, often supported by a bachelor’s degree in healthcare administration or a related field. Familiarity with health plan software, CRM tools, and knowledge of regulatory compliance systems are typically required. Strong communication, relationship-building, and problem-solving skills are essential for establishing and maintaining provider partnerships. These skills ensure effective network expansion, regulatory compliance, and high-quality service for health plan members.
What are the most commonly searched types of Provider Network Development jobs in Georgia? The most popular types of Provider Network Development jobs in Georgia are:
What are popular job titles related to Remote Provider Network Development jobs in Georgia? For Remote Provider Network Development jobs in Georgia, the most frequently searched job titles are:
What job categories do people searching Remote Provider Network Development jobs in Georgia look for? The top searched job categories for Remote Provider Network Development jobs in Georgia are:
What cities in Georgia are hiring for Remote Provider Network Development jobs? Cities in Georgia with the most Remote Provider Network Development job openings:
Remote Provider Network Development jobs near you
Network Pricing Consultant - Remote (CT/ET preferred)

Network Pricing Consultant - Remote (CT/ET preferred)

UnitedHealth Group

Atlanta, GA • On-site, Remote

$72K - $130K/yr

Full-time

Retirement

Posted 15 days ago

UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 141 frontline employees who took The Breakroom Quiz

189th of 875 rated healthcare providers

Job description

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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together
The Network Pricing Consultant supports and validates Provider Network (physicians, hospitals, ancillary facilities, etc.) contracting and unit cost management activities through financial and network pricing modeling, analysis, and reporting. Network Pricing Consultant conducts unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies. Responsibilities also include managing unit cost budgets, target setting, performance reporting, and associated financial models.
You'll enjoy the flexibility to work remotely* from anywhere within the U.S., preferably in CST or EST time zones, as you take on some tough challenges.
Primary Responsibilities:
  • Lead the design and creation of analytic models to evaluate financial impact of business strategies
  • Lead the development of strategic initiatives aimed at reducing the total cost of care
  • Lead projects to completion by contributing to database creation, statistical modeling and financial reports
  • Concisely summarize and communicate the results of complex analytics
  • Influence pricing strategies and network configuration decisions using a data driven approach
  • Provide consultative advice on use of data as subject matter expert and interpret/summarize analytical findings
  • Evaluate financial impacts of network configurations across hospital, ancillary and physician provider types
  • Conducts unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies
  • Analyze and summarize broad impact of changes in network configurations to premium price differentials
  • Work with cross-functional teams across the organization to make strategic decisions supported by data
  • Review work performed by others and recommend improvements

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:
  • Bachelor's degree in business, economics, statistics, mathematics, or a related degree
  • 2+ years of experience in creating and using financial modeling tools, spreadsheets, and information acquisition tools to perform financial impact analytics and data manipulation
  • 1+ years of analytical experience in financial analysis, health care pricing, network management, healthcare economics or related discipline
  • Advanced level proficiency with MS Excel
  • Willing and able to work Eastern Standard Time Zone hours

Preferred Qualifications:
  • 3+ years of experience working with large databases to produce a focused analysis for data manipulation and reporting
  • 1+ years of experience with provider payment methodologies and healthcare products
  • 1+ years of hospital, ancillary, and physician modeling experience
  • Experience with medical coding (CPT, DRG, ICD-9, ICD-10, etc.)
  • Proven excellent written and verbal communication, time/project management, problem solving, and organization skills

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.

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