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 Senior 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. This specific role manages FQHC/RHC (Federally Qualified Health Center/Rural Health Clinic) contracts for C&S line of business across the North Carolina market. The role evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Also ensures the network has an appropriate distribution of provider specialties and maintains strong business relationships with providers. The position is office based in any one of our North Carolina offices. Primary Responsibilities:Anticipate customer needs and proactively develop solutions to meet themServe as a key resource on complex and / or critical issues Forecast and plan resource requirementsMay lead functional or segment teams or projectsProvide explanations and information to others on the most complex issues Motivate and inspire other team members
Required Qualifications:5+ 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)2+ years of experience utilizing financial models and analysis in negotiating rates with providersAt least an intermediate level of knowledge of claims processing systems and guidelines2+ years in managing complex Provider relationships At least an Intermediate level of proficiency with MS ExcelPreferred Qualifications: Previous experience with FQHC / RHCExperience working with Medicaid contracts Excellent verbal and written communication skillsStrong interpersonal skills, establishing rapport and working well with othersAble to build and maintain strong relationships with internal and external contactsStrong customer service skillsIntermediate level of proficiency with MS PowerPoint 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: Medicaid, FQHC, Rural Health Clinic, North Carolina, Network Contracting, Charlotte, NC, Greensboro, NC, Asheville, NC, Concord, NC, Raleigh, NC, Morrisville, NC, North Carolina
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.