Submission for the position: Healthcare Provider Network Contract Manager - Telecommute for Florida - (Job Number: 943509)
Healthcare Provider Network Contract Manager - Telecommute for Florida
UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
• Support Government Risk Contracting Manager/Director to achieve Risk contracting goals and objectives for all Government LOB’s
• Provide day-to-day management of Risk contracting activities, including project management, problem resolution and other activities to drive to Capitation contract execution/maintenance
• Work effectively across lines of business and across the organization including interactions with HCE, LOB Leaders, and Capitation Operations
• Accurately and effectively communicate Government Risk contracting status to Health Plan leadership
• Manage unit cost budgets, target setting, performance reporting and associated financial models
• Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management
• Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls
• Ensure that network composition includes an appropriate distribution of provider specialties
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.
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
• 3 years of experience in a network management-related role, such as contracting or provider services
• 2 years of experience in fee schedule development using actuarial models
• 2 years of experience using financial models and analysis to negotiate rates with providers
• 2 years of experience in performing network adequacy analysis.
• In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
Preferred Qualifications:
• Undergraduate degree
• 2 years of experience in performing network adequacy analysis.
• Experience in health plans with a demonstrated focus on Capitation/value based contracting
• Intermediate level of knowledge of claims processing systems and guidelines
• Excellent verbal and written communication skills
• Ability to prioritize tasks and work effectively under time constraints
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 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)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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:  Healthcare Provider Network Contract Manager, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote, Orlando, Tampa, Miramar, Jacksonville, Tallahassee, For Myers, FL, Florida
Provider Contracting & Network Development
US-FL-Tampa
US-FL-Orlando, US-FL-Jacksonville, US-FL-Miramar, US-FL-Fort Myers, US-FL-Tallahassee
UHN Southeast
Jul 22, 2021, 11:30:25 AM
Schedule: Full-time Location(s): US-FL-Tampa