Network Contract Manager - San Francisco and Sacramento, CA
January 14, 2018
The Non-Par Network Contract Manager is a unique role within UnitedHealth Network focused on building relationships with non-par Medicare providers and bringing them into incentive programs without a contractual participation agreement. The role focuses on bringing physician groups into the incentive program and working with them throughout the year to leverage their access to tools and resources that help them maximize their bonus potential and deliver better care to members. This role specifically supports the Group Retiree business unit with tangential benefit and engagement with the broader UnitedHealthcare Medicare and Retirement organization. The ideal candidate would be a self-starter, can effectively manage ambiguity, comfortable giving presentations, demonstrates strong critical thinking skills and can efficiently and effectively manage their time. This position will be provider facing and will need to have flexibility to travel regionally to provider offices in California and surrounding states approximately 25-50% of the time. Candidates with the greatest success are those that can manage change effectively, are great relationship builders, and aren't afraid to step outside their comfort zone. Any familiarity with Medicare Stars program would be a bonus. This team member will work from home under normal work hours, but also travel out to provider offices to meet with all levels of clinical and medical office personnel (Office administrators to hospital CEOs). Primary Responsibilities:Assess and interpret provider needs and requirementsIdentify solutions to non-standard requests and problemsSolve moderately complex problems and/or conduct moderately complex analysesWork with minimal guidance; seek guidance on only the most complex tasksTranslate concepts into practiceProvide consistency in applied practices to drive long-term changeProvide explanations and information to others on difficult issuesCoach, provide feedback, and guide othersAct as a resource for others
Required Qualifications: Undergraduate degree or equivalent work experience 3+ years of experience in a network management or healthcare-related role, such as contracting or provider services3+ years of experience utilizing financial models and analysis At least an intermediate knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)At least an intermediate level of knowledge of claims processing systems and guidelinesIntermediate or higher proficiency in Microsoft ExcelAbility to travel 50% of the time to provider locations in California and surrounding states Preferred Qualifications:Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information form othersExperience in performing network adequacy analysis preferredExperience in fee schedule development using actuarial models.Familiarity with the Medicare Stars ProgramStrong interpersonal skills, establishing rapport and working well with othersStrong customer service skills Live within the vicinity of San Francisco and Sacramento, CA Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm) Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action 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. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: Network Contract Manager, health insurance, claims processing, California, CA, Sacramento, San Francisco, Numbers, Data Driven
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.