Optum Outpatient Behavioral Health Contracting - Telecommute in Washington State
Company: UnitedHealth Group
Location: Seattle
Posted on: August 7, 2022
Job 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)
The more you do, the more you learn. And as you learn you find new
doors opening that challenge you to bring your best. This
Outpatient Behavioral Health Contracting role with UnitedHealth
Group will call on your knowledge, your energy and your commitment
to making health care work more effectively for more people. We re
building better, more effective provider networks every day. In
this role, you ll use your strong contracting experience to build
and maintain our behavioral health provider networks. As you do,
you ll discover the impact you want and the resources, backing and
opportunities that you d expect from a Fortune 5 leader.
If you are located in Washington State, you will have the
flexibility to telecommute as you take on some tough
challenges.
Primary Responsibilities:
- Telecommute position and ideally will reside in Washington
State. Some minor travel in Washington State (both Eastern and
Western Washington State) will be required. Must have COVID card
documenting COVID vaccinations are complete prior to hire.
- Serve as the subject matter expert for Medicaid, Medicare and
commercial outpatient behavioral health provider/agency/group
contracting in the states you are assigned including Washington
State
- Conduct provider outreach for outpatient behavioral health
provider/agency/group network expansion
- When interacting with providers, manage provider expectations
about timelines for contracting, credentialing, reimbursement
levels and methodology, site audits, and the like
- Develops and maintains positive relationships with external
(e.g., behavioral health providers, behavioral health groups,
behavioral health agencies/community mental health
agencies/federally qualified health clinics, tribal government and
other tribal organizations, government agencies) and internal
customers
- Assemble provider agreements consisting of base agreements,
appendices and addendums, fee schedules and related documents
- Issue provider applications, agreements and related documents
to providers
- 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
- Continually Engaged; promptly responds to external and internal
customer inquiries; responsible for remaining engaged with external
and internal customers until the job is complete; responsible for
proactively keep external and internal customers updated about
status of requests; communicating with external and internal
customers via phone and email and using each appropriately to
develop strong working relationships, this includes being prepared
for scheduled calls with customers and writing professional
communications.
- Actively participate in Western Region Outpatient Behavioral
Health Contracting Team Meetings
- Serves as a positive member of the internal network team
community
- Team player; Always willing to step-up and help team members as
appropriate; respectful of team members and chain of command
- Understand health plan provider contracts and contract
language, terms and conditions and occasionally review provider s
proposed language changes and occasionally draft counter language
for review by supervisor and legal counsel)
- Models personal responsibility, dependability, reliability and
flexibility in being able to meet the needs of the team and
business; accepts responsibility and accountability for
actions
- Continually learns and retains/absorbs knowledge, information
and skills to perform the position as you work independently
- Models integrity and honesty; behaves in an honest, fair, and
ethical manner; if says work is complete, it truly is complete and
accurate according to standards. Takes the higher road when it
comes to conflict.
- Models stewardship of recourse and documents; is efficient and
effective with use of work time; archives and saves fully executed
agreements, current fee schedules and related documents in
appropriate locations; responsible with public (Medicaid and
Medicare) and private funds when negotiating reimbursement in
provider agreements
- Significant hands-on experience with behavioral health provider
contracting in the WA State Medicaid market that demonstrates a
history of success with WA Medicaid:
- payment methodologies,
- rates,
- geographic service areas/BH-ASO regions
- fee schedules,
- payment appendices,
- providers, behavioral health agencies, and groups,
- WA State Office of Insurance Commissioner filing / deeming
requirements,
- WA State Health Care Authority review and approvals, and the
other dynamics and factor at play,that are truly unique to the WA
Medicaid market
- Report to the Director of Outpatient Behavioral Health
Contracting of the Western US
- Keep Director of Outpatient Behavioral Health Contracting of
Western US and Senior Outpatient Behavioral Health Contracting
Manager Updated on timely basis about provider network development,
contracting developments, rate negotiations, rate increase
requests, emerging issues and the like
- 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
- 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 markets this
position is responsible as needed
- This is a salaried position and will require more than 40 hours
per week at times to keep up with work or complete work assignments
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 health care/managed care experience
- 3+ years of experience:
- Working at a health plan / managed care organization
contracting with behavioral health providers, especially Medicaid
outpatient behavioral health
- Negotiating behavioral health contracts between behavioral
providers and health plans / managed care providers
- Medicaid provider contracting experience
- Working with behavioral health CPT codes
- Interacting with behavioral health professionals and/or
behavioral health organizational leaders when working with
prospective providers
- 2+ years of behavioral health provider contracting experience
(actually preparing, negotiating and issuing contracts to
providers)
- 1+ years of experience with Washington State Medicaid programs
and regulations, and Medicare programs and regulations
- 1+ years of experience:
- Proficiency using Excel to develop and analyzing behavioral
health fee schedules using Excel
- Proficiency with MS Word, Excel, PowerPoint and Access
- Live in Washington State; light travel to various within the
market will be required on occasion
- Anticipate light travel to various cities throughout the state
in 2022/2023. MUST have COVID card documenting has current COVID
vaccinations prior to hire.
- Full COVID-19 vaccination is an essential requirement of this
role. Candidates located in states that mandate COVID-19 booster
doses must also comply with those state requirements..... click
apply for full job details
Keywords: UnitedHealth Group, Seattle , Optum Outpatient Behavioral Health Contracting - Telecommute in Washington State, Healthcare , Seattle, Washington
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