Sr. Network Account Manager - Remote in FL (Alachua, Marton, Lake and Surrounding Counties) - 2[...]

UnitedHealth Group; Gainesville (FL); Remote; Confidential; Full time

Job summary

Join a leading healthcare company as a Sr. Network Account Manager, overseeing provider relations for Long-Term Care. This role involves managing contracts, ensuring network adequacy, and collaborating with case management staff. Ideal candidates will have experience in Medicaid and Long-Term Care programs, strong communication skills, and the ability to work independently. The position allows for remote work in designated counties, offering a competitive salary and comprehensive benefits.

Benefits

Comprehensive benefits packages

Incentive programs

Stock purchase options

401(k)

Qualifications

• 3 years in network management-related role.
• 2 years in credentialing for providers.

Responsibilities

• Oversee provider relation networks for Long-Term Care Divisions.
• Negotiate contracts and maintain provider relationships.

Skills

Problem Solving

Communication

Customer Service

Education

High School diploma

Associate's Degree

Tools

Microsoft Excel

Microsoft Office

Job description

At UnitedHealthcare, we’re simplifying the healthcare 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. Join us to build a healthcare system that is more responsive, affordable, and equitable. Ready to make a difference? Come join us in Caring. Connecting. Growing together.

The Sr. Network Account Manager will oversee provider relation networks for the Community & State Long-Term Care Divisions. Responsibilities include provider contracting, credentialing and re-credentialing, provider relations, education, managing the provider portal and EVV, claims support, ensuring network adequacy, closing gaps, and tracking/reporting network metrics. This role collaborates with case management staff to support network needs related to member benefits and services, including working with SCAs and PNRs (Single Case Agreements and Provider Network Requests).

The goal of our Long-term care network team is to manage and fulfill provider network requirements for the health plan in accordance with state regulations.

In this role, you will be expected to:

1. Apply basic knowledge of provider network functions and thrive in a fast-paced environment.
2. Demonstrate intermediate proficiency in Microsoft Office programs (Teams, Outlook, Word, Excel, PowerPoint); knowledge of Microsoft Access is a plus.
3. Use problem-solving skills and take initiative to resolve issues.
4. Work independently with attention to detail, flexibility, and the ability to multi-task to meet deadlines.
5. Possess knowledge of Medicaid and Long-Term Care (Home and Community Based) programs.
6. Maintain good communication skills and build relationships with providers.
7. Experience with Health Plan contracts to ensure appropriate provider distribution.
8. Display professional work ethics and collaborate effectively with cross-departmental teams.
9. Perform other duties as required.

If located in certain counties, you may have the flexibility to work remotely, including Alachua (Gainesville), Putnam, Marion (Ocala), Lake (The Villages), Sumter, Hernando, Citrus, Levy, Dixie, Gilchrist, Lafayette, Suwanee, Hamilton, Columbia, Union, Bradford.

Primary Responsibilities:

1. Service the Florida SMMC Medicaid/Long-Term Care business.
2. Develop and maintain a geographically broad and stable provider network, balancing cost, access, and quality.
3. Negotiate contracts in compliance with company standards.
4. Build and maintain relationships with providers, ensuring appropriate LTC and HCBS specialties are represented.

We offer a challenging environment with clear performance expectations and development opportunities.

Required Qualifications:

1. High School diploma.
2. At least 3 years in a network management-related role (contracting or provider services).
3. At least 2 years in credentialing for ancillary/facility/group providers, with knowledge of Florida requirements.
4. Experience with Medicaid/Long Term Care contracts, claims, and credentialing.
5. Advanced Excel skills (3+ years).
6. Proven customer service skills.
7. Fluency in English; excellent communication skills.
8. Ability to travel approximately 25%, including overnight stays.

Preferred Qualifications:

1. Associate's Degree or higher.
2. Ability to adapt to a fast-changing environment.
3. Strong interpersonal skills and rapport-building abilities.
4. Bilingual in English and Spanish is a plus.

*Remote work is permitted in designated counties, subject to company policies.

The salary range is $71,600 to $140,600 annually, based on experience, education, and location. Benefits include comprehensive packages, incentive programs, stock purchase options, and 401(k). We are committed to diversity, equity, and inclusion, and an equitable workplace for all.

Our mission is to help people live healthier lives and improve the healthcare system. We are dedicated to reducing disparities and promoting equitable care. UnitedHealth Group is an Equal Opportunity Employer and a drug-free workplace, requiring pre-employment drug testing.