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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 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 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 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 are the most commonly searched types of Provider Network Development jobs in Michigan? The most popular types of Provider Network Development jobs in Michigan are:
What are popular job titles related to Remote Provider Network Development jobs in Michigan? For Remote Provider Network Development jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Remote Provider Network Development jobs in Michigan look for? The top searched job categories for Remote Provider Network Development jobs in Michigan are:
What cities in Michigan are hiring for Remote Provider Network Development jobs? Cities in Michigan with the most Remote Provider Network Development job openings:
Remote Provider Network Development jobs near you
Provider Engagement Representative - Remote in Michigan

Provider Engagement Representative - Remote in Michigan

UnitedHealth Group

Livonia, MI • On-site, Remote

$60.20K - $107.40K/yr

Full-time

Retirement

Posted 12 days ago

UnitedHealthcare rating

7.8

Company rating: 7.8 out of 10

Based on 651 frontline employees who took The Breakroom Quiz

102nd of 864 rated healthcare providers

Job description

Optum Home & Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our Senior Community Care (SCC) team, we work to provide care to patients at home, nursing homes and assisted living for senior housing. This life-changing work adds a layer of support to improve access to care. We're connecting care to create a seamless health journey for patients across settings. Join us to start Caring. Connecting. Growing together.
The Provider Engagement Representative (PER) will manage business relationships for contracted Skilled Nursing Facilities (SNF) for all UnitedHealthcare Community Plan of Michigan for the Michigan Medicaid program, including working on end-to-end provider issues and call quality, and training & development of external provider education programs. The PER will conduct both in-person and virtual meetings, along with related provider relations activities, to support the overall operations of the Medicaid program
If you are located in Michigan, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
  • Develop and maintain overall UnitedHealthcare business relationships with Skilled Nursing Facilities
  • Serve as the primary point of contact for assigned facilities ensuring timely and effective communication
  • Conduct routine outreach (virtual and on-site) to assess provider needs, concerns, and satisfaction
  • Designs and implements programs to build and nurture positive relationships between the health plan, nursing facility providers and business office managers
  • Direct and implement strategies relating to the development and management of a provider network
  • Support all education opportunities on UnitedHealthcare businesses which include in person and telephonic interactions
  • Identifies gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs
  • Provide explanations and information to others on topics within area of expertise
  • Prioritize and organize own work to meet deadlines cross functionally within the organization
  • Investigate non-standard requests and issues, prior to escalation if needed
  • Compass Data Base - update & maintain regularly with information following interactions with nursing facilities
  • Provide outreach and education on updated policies, new initiatives, performance, and others as necessary

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:
  • 2+ years of experience with Medicare/Medicaid regulations
  • Experience working in a skilled nursing facility
  • Billing experience in a skilled nursing facility
  • Demonstrated intermediate level of proficiency with MS Word, Excel, PowerPoint and, Outlook
  • Driver's License and access to reliable transportation
  • Ability to travel 25% of the time within Michigan

Preferred Qualifications:
  • 2+ years of provider relations or provider network management experience
  • Ability to prioritize and meet deadlines
  • Demonstrated familiarity with claims processing and issue resolution

*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 $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
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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