Outpatient Behavioral Health Medicaid Contracting – Telecommute from Idaho

UnitedHealth Group
Published
July 13, 2021
Location
Atlanta, GA
Category
Job Type

Description

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

If you are located in the state of Idaho, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Serve as the subject matter expert Optum Idaho Medicaid outpatient behavioral health provider/agency/group contracting
  • Conduct provider outreach for Optum Idaho Medicaid outpatient behavioral health provider/agency/group network expansion
  • When interacting with providers, manage provider expectations about timelines for contracting, credentialing, reimbursement, site audits, contract amendments, rate increases, fee schedule adjustments, and the like
  • Assemble provider agreements consisting of base agreements, appendices and addendums, fee schedules, supervisory protocols, and related documents as appropriate
  • Issue provider applications and related information about apply to join the network, agreements and related documents to providers/agencies/groups within Idaho and contiguous states that are prospective Idaho Medicaid candidates
  • Gather completed provider applications and other documents that accompany the application, other documents required by state law and/or company policy; review these documents for completeness, accuracy, organize, and submit documents for credentialing
  • Coordinate and follow-up with Optum Provider Relations Advocates to ensure timeliness of submission of applications and related documents
  • Actively participate in Western Region Outpatient Behavioral Health Contracting Team Meetings
  • Keep direct supervisor, Optum Director of Outpatient Behavioral Health Contracting of Western US, updated on timely basis about provider network development, contracting developments, rate negotiations, rate increase requests, emerging issues and the like; also keep / Senior Outpatient Behavioral Health Contracting Manager updated as well
  • Ability to learn and use proprietary and other software programs for sending, updating and storage of provider/agency/group contracts and numerous fee schedules and related contractual documents
  • Develop, update and maintain numerous fee schedules
  • Actively participate in joint Provider Relations – Outpatient Behavioral Health Contracting Meetings to ensure continuity of communication and coordination between
  • Email and phone communication with internal and external customers throughout each day
  • Ability to work in fast-paced work environment with multiple competing priorities and people from multiple functions within company and multiple external customers and ability to re-prioritize as work and customer deadlines and demands change throughout day and week
  • Reports directly to Director of Outpatient Behavioral Health Contracting of Western US
  • Exceptional verbal (telephone, video conferencing and in-person) and written communication skills (emails, memos and letters)
  • Ability to use tact and diplomacy when appropriate
  • Ability to use superior discernment in stakeholder and provider communications
  • Ability to communicate effectively, professionally and comfortably with staff at multiple levels and from multiple functional areas and from various professional fields within provider/agency/group organizations (e.g., CEOs, CFOs, COOs, Contract Directors, Clinical Directors, Medical Directors, Program Directors, and various types of direct service professionals)
  • Ability to engage in light travel within the market as needed

Are you ready for a challenge? You’ll be part of a performance driven, fast paced organization that is serving multiple markets and you’ll be charged with educating and building relationships with providers to evolve ongoing processes and programs.

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:

  • High school diploma or equivalent work experience
  • 4+ years of behavioral health/managed care experience
  • 2+ years of behavioral health provider contracting experience (actually preparing, negotiating and issuing contracts to providers); Idaho Medicaid behavioral health provider contracting experience
  • 1+ years of experience with Idaho Medicaid programs and regulations (especially Idaho Medicaid behavioral health), and Medicare programs and regulations
  • Proficiency with MS Word, Excel, PowerPoint and Access
  • Able to occasionally travel around the state (both day trips and overnight)
  • Telecommute position and must live in Idaho

Preferred Qualifications:

  • Undergraduate degree, preferably in business administration, public administration, healthcare administration, law, social services or related field. Master’s degree in one of these fields  
  • Experience and knowledge with the Idaho Medicaid health insurance and behavioral health insurance communities/markets
  • Experience and knowledge of larger Idaho Medicaid outpatient behavioral health provider/agencies/groups communities and markets
  • Idaho Medicaid, including but not limited to state agencies, programs, laws, rules and regulations, related to Medicaid
  • Proficient with Excel, and previous experience developing, updating and maintaining provider outpatient behavioral health Medicaid fee schedules
  • Experience and knowledge of Optum tools including but not limited to:
  • Saleforce
  • OHBS FACETS
  • DocuSign or related software program
  • ePUFs (electronic provider update forms)
  • PLINX
  • SURE Reports
  • FAT (Financial Analysis Tool)
  • Fee Schedule Pricing Profiles
  • 3+ years working at a health plan / managed care organization contracting with behavioral health providers, especially Medicaid outpatient behavioral health
  • 3+ years negotiating behavioral health contracts between behavioral providers and health plans / managed care providers
  • 3+ years Medicaid provider contracting experience
  • 3+ years working with behavioral health CPT codes
  • 3+ years interacting with behavioral health professionals and/or behavioral health organizational leaders when working with prospective providers
  • 1+ years of experience proficiently using Excel to develop and analyzing behavioral health fee schedules using Excel

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords:  Outpatient Behavioral Health Medicaid Contracting, Idaho, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote

Apply
Drop files here browse files ...

Related Jobs

Purchasing Clerk   Houston, TX new
July 30, 2021
July 30, 2021
Mailroom Clerk   Houston, TX new
July 30, 2021

Author: