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, ancillary groups, 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 trusted business relationships with Hospital, Physician, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties. Along with improving the provider experience with NPS scores. Primary Responsibilities:Assess and interpret provider/member 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 experienceAbility to present complex materials to executives, perform solid financial analysis, use of data bases in an effective manner, manage projects to deliver timelyCapitation experience and oversight management of provider groupsReporting to the Director of Network Contracting
Required Qualifications:Undergraduate degree or work equivalent experience 3+ years of experience in a network management - related role, such as contracting or provider servicesIn-depth knowledge of capitation reimbursement methodologies and delegated claims with utilization management (UM)3+ years of experience in capitation rate development 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 guidelinesExperience in developing narrow networks and meeting network adequacy guidelinesMust live within commutable distance of the location listed for this specific career opportunityPreferred 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 others.Strong customer service skills 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. Keywords: Capitation, capitation reimbursement methodologies and delegated claims with utilization management (UM), Chicago, IL, Schaumburg, IL, Lisle, IL, Illinois, Flexible Schedule, Contracting, Network Management, Provider Services, Capitation Rate Development, Claims, Hospital, Physician, or Ancillary
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.