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 Director of Network Programs is responsible for the successful program design, compliance with network requirements, network assessment and selection, provider customer satisfaction and program implementations in support of the Health Plan's provider network operations strategy. Working for a leading edge and innovative health plan, works on front lines transforming health care to better serve our member customers and provide for the highest provider satisfaction. Strong focus on Home and Community Based Care and Nursing Facility services. Leads and support Medicaid Health Plan's network strategy for all provider networks. Performs network analysis and strategy development and implementation; obtain data, verify validity of data, and analyze data as required, and analyze network availability and access. Other responsibilities may also include making recommendations regarding use, expansion, selection of networks for various products based on that analysis. Primary Responsibilities:Own end -to - end processes for the health plan Participates with the senior leadership team and shared services partners, contributing to formulating strategies that improve the quality of our networks and associated support systems and processes Leads a team of top notch and high performing provider advocate associatesDevelops functional, market level, and / or site strategy, plans, production and/or organizational prioritiesIdentifies and resolves technical, operational and organizational problems outside own teamInterfaces with providers, associations and State agencies on a regular basis, via email, phone and in - person
Required Qualifications:Undergraduate degree or 5 years of equivalent experience5+ years of experience working with a managed care organization, health insurer, or consultant in a network management / contract management role, such as contracting, provider services, etc.5+ years of experience in data analysis5+ years of experience managing staff3+ years of project management or project lead experienceIntermediate level of proficiency with all facility / ancillary contract reimbursement methodologies5+ years experience with claims systemsStrong knowledge of business processes that impact facility/ancillary contact loading and auditing 3+ years experience with contract submission, validation and maintenance Advanced proficiency in MS Office (Excel, Access and PowerPoint)Preferred Qualifications:Ability to work with various internal business partners, leading and driving operational performanceStrong communications skills, written and verbal, as well as strong relationship building capabilitiesPresent information to senior leaders, both internal and external to UHCVendor management and supportAbility to develop presentations and collateral to support provider networkFlexibility to travel to provider offices and attend meetings with various stakeholders across KansasPrior leadership skills coaching and developing employees to peak performanceGood strategic abilities, including developing strategic business plans, in collaboration with other health plan leaders Excellent communication skills, including ability to communicate effectively with various levels of leadership Ability to convey complex or technical information in a manner that others can understandCareers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place 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: managed care, network management, contract management, data analysis, project management, claims systems, Overland Park, KS, Kansas
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.