Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm) The Network Contract Manager develops the provider network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.) yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners. Network Contract Managers evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties. Primary Responsibilities: Assess and interpret customer 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 explanations and information to others on difficult issuesCoach, provide feedback, and guide othersAct as a resource for others with less experienceNetwork Contract Manager needed for growth and expansion in the Texas market development efforts (Moonshot) to include new development and current ongoing development efforts. The continued growth in Dallas/ Fort Worth supports the need for additional network staff for contracting and growth.
Required Qualifications: Undergraduate degree or equivalent related work experience4+ years of experience in a network management-related role, such as contracting or provider servicesIn-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)3+ years of experience utilizing financial models and analysis in negotiating rates with providersAt least an intermediate level of knowledge of claims processing systems and guidelines3+ years of experience in performing network adequacy analysisTravel 80% and overnight stay when expanding new marketsPreferred 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 othersStrong interpersonal skills, establishing rapport and working well with othersStrong customer service skillsCareers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 90,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to 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, network management, contracting, provider services, RBRVS, claims processing, San Antonio, Dallas, TX, Texas
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.