[Hiring] Credentialing Specialist @UnitedHealth Group

Role Description

This position will be telecommute with occasional travel in Miami - 25%. The goals of our LTC network team are to manage and carry out the provider network requirements and all functions related to credentialing and re-credentialing.

In this role you will be expected to:

• Oversee/Facilitate/Complete receipt of provider applications
• Oversee/Facilitate/Complete analysis and verification of provider credentials
• Perform other assignments as required

If you are located in FL, you will have the flexibility to work remotely as you take on some tough challenges.

Primary Responsibilities:

• Gather and process Florida State Required (AHCA) Homelike Environment Assessments (HLEs)
• Analyzes and Investigates
• Prioritizes and organizes own work to meet deadlines
• Provide explanations and information to others on topics within area of expertise
• Apply basic knowledge of provider network functions, ability to work in a fast-paced environment
• Intermediate skill level in Microsoft programs (Outlook, Word, Excel) and spreadsheet management
• Ability to take initiative and use problem-solving skills for issue resolution
• Depend minimally on others for instruction, guidance or direction
• Must be attentive to detail, work with flexibility, and have the capability of multi-tasking to meet deadlines and deliverables
• Possess knowledge in Medicaid and LongTerm Care programs and services
• Must have good communication skills; and the ability to build and retain relationships with Physician or Ancillary providers
• Review and process, apply functional expertise for provider/ancillary credentialing and re-credentialing
• Assist with contract management to include contract loading submissions
• Display professional work ethics in a structured work environment
• Perform other duties as required

Qualifications

• 3+ years of experience/knowledge in the Agency for Healthcare Administration Statewide Medicaid Managed Care (SMMC) Medicaid/Long Term Care business
• 3+ years working in a network management-related role, such as provider services, credentialing, contract processing
• 3+ years of experience and/or certification in ancillary credentialing, to include knowledge of credentialing requirements for the State of Florida
• 3+ years of experience in fee schedule management
• 3+ years of experience in network adequacy analysis
• Proven excellent verbal and written communication skills
• Proven intermediate level in Microsoft Word, Excel, PowerPoint, Access
• Proven solid interpersonal skills, establishing rapport and working well with others
• Proven solid customer service skills
• Bilingual - English/Spanish

Preferred Qualifications

• English/Spanish bilingual

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)

Company Description

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.

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.