2

Remote Provider Network Management Jobs in Ohio (NOW HIRING)

$74K - $97K/yr

This position is for an IT Spec (Infosec/Network) , Position Description Number D2341000 , located ... provided a basic knowledge of data processing functions and general management principles that ...

Provide student counseling and psychoeducational evaluations * Participate in IEP meetings ... Experience participating in IEP meetings, acting as case manager, and completing comprehensive case ...

... managed across all Wendy's network ecosystems (backbone, cloud, Internet, campus ... Responsibilities * Provides third level support and troubleshooting for all network services.

next page

Showing results 1-20

Remote Provider Network Management information

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

To thrive in Remote Provider Network Management, you need expertise in healthcare provider relations, contract negotiation, and a solid understanding of health plan regulations, often supported by a degree in healthcare administration or a related field. Familiarity with provider network management software, data analytics tools, and knowledge of regulations like HIPAA are typically required. Excellent communication, problem-solving abilities, and attention to detail are essential soft skills for building strong partnerships and managing network performance. These skills and qualifications ensure efficient network operations, regulatory compliance, and high-quality service for both providers and members.

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

AspectRemote Provider Network ManagementRemote Provider Relations Specialist
CredentialsHealthcare administration, network management certificationsCustomer service, healthcare communication certifications
Work EnvironmentHealthcare organizations, insurance companies, remote office settingsHealthcare providers, insurance companies, remote customer support
Industry UsageManaging provider networks, credentialing, contractingBuilding provider relationships, resolving provider issues

Remote Provider Network Management focuses on overseeing healthcare provider networks, including credentialing and contracting. In contrast, Remote Provider Relations Specialists primarily handle communication and relationship-building with providers. Both roles require healthcare knowledge but differ in their core responsibilities and focus areas.

How does a Remote Provider Network Management professional typically collaborate with healthcare providers and internal teams?

Remote Provider Network Management professionals frequently coordinate with healthcare providers via virtual meetings, emails, and secure online portals to address contract negotiations, credentialing, and performance issues. They also work closely with internal departments such as claims, quality assurance, and customer service to ensure seamless provider onboarding and ongoing support. Effective communication and strong relationship-building skills are essential, as much of the collaboration happens through digital channels. This setup allows for flexibility but requires self-motivation and proactive engagement to maintain strong provider networks.

What is a Remote Provider Network Management role?

A Remote Provider Network Management role involves overseeing relationships and contracts with healthcare providers, such as doctors, hospitals, and clinics, while working remotely. Professionals in this field are responsible for recruiting new providers, maintaining communication, ensuring compliance with regulations, and addressing network issues. They play a key part in expanding and maintaining a healthcare organization's provider network to ensure members have access to quality care. This job typically requires strong organizational, negotiation, and communication skills, as well as familiarity with healthcare regulations and provider credentialing processes.
What are the most commonly searched types of Provider Network Management jobs in Ohio? The most popular types of Provider Network Management jobs in Ohio are:
What are popular job titles related to Remote Provider Network Management jobs in Ohio? For Remote Provider Network Management jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Remote Provider Network Management jobs in Ohio look for? The top searched job categories for Remote Provider Network Management jobs in Ohio are:
What cities in Ohio are hiring for Remote Provider Network Management jobs? Cities in Ohio with the most Remote Provider Network Management job openings:
Network Pricing Consultant - Remote in CST/EST preferred

Network Pricing Consultant - Remote in CST/EST preferred

UnitedHealth Group

Independence, OH • On-site, Remote

$72K - $130K/yr

Full-time

Medical, Retirement

Posted 26 days ago


UnitedHealth Group rating

7.5

Company rating: 7.5 out of 10

Based on 140 frontline employees who took The Breakroom Quiz

223rd of 870 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 .
This opportunity is all about complexity and meaningful impact. You will play a key role in accurately and effectively pricing our provider network across East Region markets, including Kentucky, Indiana, and Ohio. Success in this role requires strong analytical thinking, creativity in interpreting contract structures, and the ability to leverage available resources to develop accurate and reliable pricing.
As a Network Pricing Consultant, you will support and validate Provider Network (hospital, physician, ancillary facilities, etc.) contracting and unit cost management activities through financial modeling, analysis, and reporting. You will conduct unit cost and contract valuation analysis to support negotiations and unit cost management strategies, while managing unit cost budgets, targets, and performance reporting.
Challenge can often be its own reward, but why settle for challenge alone when you can also be supported, mentored, and developed in a fast-paced and impactful career? With UnitedHealth Group, you can expect all of the above, every day. Here's your opportunity to combine analytical expertise and collaborative problem-solving as you strike the balance between health care costs and resources. In this role, you'll ensure that health care contracts are priced accurately and fairly for all involved, backed by the resources and stability of a Fortune 5 leader.
While this role primarily supports East Region markets, you'll enjoy the flexibility to work remotely from anywhere in the U.S.
Primary Responsibilities:
  • Support network pricing strategies and tactics in collaboration with local network field leaders and network managers
  • Analyze financial impact of provider contracts
  • Evaluate financial impact of corporate initiatives and external regulations
  • Review payment appendices and develop options for various contracting approaches and methodologies
  • Communicate financial impact findings and insights to stakeholder groups
  • Conduct financial and network pricing modeling, analysis, and reporting
  • Provide mentorship and engage in detailed peer review activities
  • Perform unit cost and contract valuation analysis to support network contracting and unit cost management strategies
  • Lead large and complex analytical projects to support key business objectives
  • Influence pricing strategies and rate development by identifying opportunities or safeguarding favorable structures
  • Collaborate with Network Management to strategize rates or contract methodologies
  • Review competitive analysis to determine appropriate provider pricing

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:
  • Undergraduate degree in Math, Statistics, Finance, Economics, or related field
  • 4+ years of analytical experience
  • 3+ years of experience with provider payment methodologies and healthcare products
  • Experience presenting to internal or external stakeholders
  • Financial impact analysis and data manipulation skills
  • Advanced proficiency in Microsoft Excel
  • Ability to interpret financial modeling results and develop forecasts
  • Ability to manage multiple projects simultaneously
  • Ability to research and solve problems independently

Preferred Qualifications:
  • Experience with advanced statistical functions for financial modeling
  • Experience with various payment methodology types
  • Knowledge of commercial, Medicare, and Medicaid PPO/HMO revenue and expense patterns
  • Solid interpersonal, collaboration, negotiation, and communication abilities

*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.

What UnitedHealth Group employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom