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Remote Provider Network Development Jobs in Minnesota

Network Engineer

Minneapolis, MN · On-site +1

$78.10K - $128.50K/yr

Bio-Techne, and all of its brands, provides tools for researchers to further treat and prevent ... Experience with VPN technologies (IPsec, SSL) and remote access solutions. * Strong troubleshooting ...

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Remote Provider Network Development information

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

Network Contract Manager - Remote

UnitedHealth Group

Eden Prairie, MN • Remote

$72.80K - $130K/yr

Full-time

Retirement

Posted 10 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 is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health
outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come makes an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

 

Creating and fine-tuning provider networks helps improve access to health care for millions. It's an outstanding opportunity to have more meaning and purpose in your career.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

 

Primary Responsibilities:

  • Negotiate and prepare facility agreements that are geographically competitive
  • Achieve objectives for unit cost performance and trend management
  • Prepare and negotiate value-based, performance-based, and creative contracts for assigned regional facilities
  • Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards, and other key process controls
  • Collaborates with Provider Network team to ensure that network composition includes an appropriate distribution of provider specialties
  • Participate in regional and state-based contracting and/or provider network calls; Possess a willingness and ability to provide explanations and information to others on difficult and/or complex contracting issues (i.e. subject matter expert)

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:

  • 4 years of experience in a network management-related role, such as contracting or provider services
  • 3 years of experience in fee schedule development using actuarial models
  • 3 years of experience using financial models and analysis to negotiate rates with providers
  • 3 years of experience in performing network adequacy analysis.
  • In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
  • Proven in-depth knowledge of fee-for-service (FFS), risk sharing, and value-based or "creative" contracting
  • Proven intermediate level of knowledge of claims processing systems and guidelines
  • Demonstrable knowledge of managed care contracting concepts, provider network access, and CMS and Medicaid rules

*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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