Network Program Consultant, Accountable Care Organizations - VA. - Full-time / Part-time

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 Program Consultant is responsible for successful network program design, compliance, network assessment and selection, and program/product implementation. This includes enterprise-wide Clinically Integrated Network teams that focus on specific clinical area Lines of Service (e.g., Cardiology, Women's Health, Oncology, etc.) to improve quality and affordability through improvements in appropriateness and effectiveness. Network Program Consultants may perform 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.

This role requires strong project management background, excellent data analysis skills,  and the ability to respond to rapid/continuous change effectively. 

This role will have a primary focus on activities tied to the success of two active Accountable Care Organizations in Virginia.  The ideal location is the UHG office in Reston, Virginia. The Richmond office is also a possiblity.

Primary Responsibilities:

• Anticipate customer needs and proactively develop solutions to meet them


• Serve as a key resource on complex and/or critical issues


• Perform complex conceptual analyses


• May lead functional or segment teams or projects


• Provide explanations and information to others on the most complex issues


• Motivate and inspire other team members

Required Qualifications:

• 
  
  4+ years experience in a role requiring in depth knowledge of provider contracts


• 3+ years demonstrating effective project management ability


• 3+ years work requiring reporting and analysis of healthcare data 


• 3+ years experience in a role working with the provider community


• 2+ years demonstrated presentation skills including the presentation of complex data


• Advanced proficiency in MS Office (Excel, Access and PowerPoint)

Desired Qualifications:

• 4+ years of experience in claims processing, provider data maintenance, contracting, or contract loading


• Intermediate level of proficiency with all facility/ancillary contract reimbursement methodologies


• Strong knowledge of business processes that impact facility/ancillary contact loading and auditing


• 3+ years of experience with contract submission, validation and maintenance


• Project Management Certifications (PMP) and experience with project management software


• Excellent communication skills 


• High level of attention to detail


• Ability to track commitments through execution


• Ability to establish strong productive relationships with both internal and external stakeholders


• Undergraduate or higher level degree

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 14 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: 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 Program manager, ACO Manager, Managed Care, Healthcare, Network Program Specialist, network requirements, network assessment, network selection, network data management, provider data analysis, medical claims, claims processing, claims resolution, medical coding, project management, Reston, Richmond, Virginia, VA