Strategic Network & Provider Relations Specialist

United Health Centers; Fresno (CA); On-site; USD 30,000 - 43,000; Full time

Benefits offered by this job

Medical, Dental, and Vision insurance

Paid time off and paid holidays

401k plan with matching contribution

Educational Assistance

Employee discounts and more

Job summary

United Health Centers in Fresno, CA is seeking a Network Engagement Specialist to coordinate care with in- and out-of-network providers and facilities. You will manage provider communications, referrals, LOAs, grievances, and data exchanges to improve member satisfaction.

In this role, you will educate hospitals and ancillary partners on UHC processes, route cases per guidance from Medical Directors, and support cross-functional teams to enhance network performance.

Qualifications

• High School Diploma or GED required.
• Bachelor's degree in Business, Healthcare Admin, Communications or related field preferred.
• Completed training program in Medical Assisting from Accredited College preferred.
• Two (2) or more years of experience in the healthcare industry navigating relationships around providers and insurance networks is preferred.
• Valid CA driver’s license is required.
• Bilingual (English/Spanish) is preferred.
• Excellent communication and negotiation skills; ability to persist and be persuasive.
• Ability to prioritize multiple responsibilities and manage a large workload within budget and timelines.
• Must have problem-solving skills and the ability to develop alternatives.
• Must prepare clear, concise written reports and documents.

Responsibilities

• Coordinate care with in- and out-of-network hospitals and providers.
• Educate hospitals and ancillary providers on UPN’s processes and workflows.
• Route referrals and manage provider communications and grievances.
• Support credentialing and licensing workflows with providers.
• Ensure timely referrals and service delivery per MD/AMD guidance.

Skills

Bilingual (Eng/Spa)

Communication skills

Problem solving

Time management

Report writing

Computer skills

Education

High School Diploma or GED

Bachelor's degree preferred

Medical Assisting training preferred

Job description

United Health Centers in Fresno, CA is seeking a Network Engagement Specialist to coordinate care with in- and out-of-network providers and facilities. You will manage provider communications, referrals, LOAs, grievances, and data exchanges to improve member satisfaction.

In this role, you will educate hospitals and ancillary partners on UHC processes, route cases per guidance from Medical Directors, and support cross-functional teams to enhance network performance.