Medicaid Contract Specialist – Telecommute – Eden Prairie – UnitedHealth Group


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 is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It’s an opportunity to do your life’s best work.(sm)

The Medicaid Contract Specialist is responsible for managing administrative tasks aligned with the Skilled Nursing Facility contracting process, as well as providing internal support. The Medicaid Contract Specialist will create contracts, support critical reviews to ensure demographic, credentialing and contract accuracy prior to submission. The Medicaid Contract Specialist will play an active role through the load and audit process with all applicable contract loading teams, as well as be accountable to review audit results post-installation. The Medicaid Contract Specialist will also be accountable to manage and submit all daily and mass State Rate updates to all applicable contract loading teams on behalf of Network Management.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Build and maintain relationships with Optum Network Management, Health Plan and contract loading teams to ensure accurate contract set up results are obtained and maintained
  • Manage Skilled Nursing Facility (SNF) contracts, including validation of demographics, credentialing, and system accuracy prior to installation in applicable systems
  • Coordinate with quality audit team both pre- and post-implementation to ensure accuracy of contract loading and claim payment accuracy based on contract intent
  • Minimize contracting and claim rework associated with incorrect SNF contract set up
  • Experience with Medicare, Commercial, and Medicaid will be of value in this role
  • Any other projects or duties as assigned
  • Use pertinent data and facts to identify and solve a range of problems within area of expertise
  • Prioritize and organize own work to meet deadlines
  • Be a key resource for addressing questions regarding contract language, contract set-up, payment methodology and other processes
  • Attention to detail, problem solving, and establishing and maintaining solid business relationships are crucial for success in this role

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:

  • 3+ years of experience in a network data management related role in a managed care environment, such as contract loading or provider data analysis
  • Experience using NDB, Cosmos, CSP Facets and Emptoris
  • Intermediate proficiency with MS Office suite, including Word and Excel

Preferred Qualifications:

  • 2+ years of experience working with reporting tools and generating effective reports
  • 2+ years of experience with claims processing, resolution, or recovery
  • Experience with facility claims processing systems and guidelines
  • Medicaid, Medicare and Commercial product knowledge
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

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)

Colorado, Connecticut or Nevada Residents Only: The hourly range for Colorado residents is $26.15 to $46.63. The hourly range for Connecticut / Nevada residents is $28.85 to $51.30. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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

Diversity creates a healthier atmosphere: Optum is an Equal Employment Opportunity 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.

Optum and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.


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