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Provider Network Contracting Specialist

Ewings Associates Fernandina Beach, FL
  • Posted: over a month ago
  • Other
EWINGS is in search of Provider Network Contracting professionals for an exciting, high-profile engagement with our client UnitedHealthcare (UHC). This is a 15-18-month assignment with the possibility of extending beyond 2020, and it’s possible that contractors will be asked to convert to full-time employment status with UHC. Contractors will be able to telecommute; however, they may occasionally be asked to visit with healthcare providers in-person. Contractors will be responsible for supporting our client in their efforts to expand Workers Compensation networks across Virginia, Florida, Georgia, and Pennsylvania. Candidates must have network development and contracting experience for Workers Compensation plans in one or more of these states.

This network expansion project is scheduled to launch in August. Don’t miss your chance to be considered for this highly coveted position.

Candidates will be invited to participate in a phone interview with the client before they will be accepted to the team.

As the leader in supporting large-scale network development initiatives for the nation’s leading insurers, EWINGS consistently offers their contractors the opportunity to work on project teams responsible for the largest, high-profile network engagements happening. EWINGS is currently supporting the Veteran’s Administration - Community Care Network build with a team of over 100 network professionals.

POSITION DESCRIPTION: Workers Compensation Network Contractor - Develop a Worker's Comp provider network yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance, trend management, and produces an affordable and predictable product for customers and business partners. Worker's Comp provider network contractor will evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining relationships with providers ensuring the network composition includes an appropriate distribution of provider specialties, in this role, you will be expected to identify solutions to non-standard requests and problems, solve moderately complex problems and/or conduct moderate analyses.

QUALIFICATIONS: Undergraduate degree, 4+ years of experience in a network management-related role. Worker's Comp experience, contracting or recruiting a range of healthcare providers including physicians, specialists, ancillaries, etc. In-depth knowledge of reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS) preferred. At least an intermediate level of knowledge of claims processing systems and guidelines. 4+ years of experience in performing network adequacy analysis. Intermediate level of experience with MS Excel required. Excellent 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. Strong interpersonal skills, establishing rapport and working well with others. Experience working in a high performing team environment that focuses on productivity and achieving results.

IMPORTANT: Consultants will be engaged as hourly Independent Contractors working for EWINGS, INC without benefits. When applying please provide the date of when you would be available to start a new assignment and a range of your hourly rate expectations. HIRING PROCESS OVERVIEW: Interview with EWINGS Recruiter; Interview with Client; if accepted by the client, EWINGS will conduct a Reference Check, Background Check, and Drug Test; Onboarding through both EWINGS and the client. We look forward to potentially working with you! EWINGS, INC. www.ewingsinc.com

Ewings Associates

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Fernandina Beach, FL
32034 USA

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