Network Contract Manager- Northern New England - Telecommute
January 13, 2018
It's a big step forward when you realize that you've earned the trust to lead a team. Now, let's determine just how big that step can be. Take on this managerial role with UnitedHealth Group and you'll be part of a team that's reshaping how provider networks evolve and how health care works better for millions. As a manager within our network contracting team, you'll guide the development and support of Provider Networks as well as unit cost management activities through financial and network pricing modeling, analysis, and reporting. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 6 leader. This role focuses on development of the Provider network for Northern New England. This will include Federally Qualified Healthcare Centers. The network created will yield 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. The role will 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 physician or hospital providers, and ensuring the network composition includes an appropriate distribution of provider specialties. The ideal candidate will have a thorough knowledge of the Northern New England (MA/ME/NH/VT) Healthcare Market. Additionally, the candidate should have knowledge of ICD-10, CPT-4 and other coding. Primary Responsibilities:Assess and interpret customer needs and requirementsIdentify solutions to non-standard requests and problemsWork with minimal guidance; seek guidance on only the most complex tasksProvide explanations and information to others on difficult issuesAct as a resource for others with less experienceIf you are located within the vicinity of Portland, Maine, Manchester, NH, Burlington, Vermont and Massachusetts , you will have the flexibility to telecommute* as you take on some tough challenges.Get ready for some significant challenge. This is an intense, fast-paced environment that can be demanding. In addition there are some data challenges and unique problems that need to be solved related to gaps in the process.
Required Qualifications:Undergraduate degree or equivalent work experience 3+ 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 negotiating rates with providersIntermediate or higher level of proficiency in MS ExcelPreferred to live within the territory of (Vermont, Maine, New Hampshire, MA.) Preferred Qualifications:Experience with Federally Qualified Health Centers (FQHC)Experience in fee schedule development Excellent verbal and written communication skills; ability to speak clearly and concisely, and ability to convey complex or technical information Strong interpersonal skills, establishing rapport and working well with othersStrong customer service skills *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Creating and fine tuning provider networks helps improve access to health care for millions. It's an outstanding opportunity to have more meaning and purpose in your career. Join us. Find out how you can start doing your life's best work.SM 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.SMDiversity 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 Contracting, Provider Relation, (Vermont, Maine, New Hampshire, Massachusetts) , Contracting, Provider Relations, RBRVS, Medicare, Provider Services
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.