Network Contract Manager - San Antonio, TX or Dallas, TX - 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 Manager ensures that there is an adequate network, provide ongoing tracking and monitoring of that network and act as a liaison to the health plan with the providers in the network. Acts as the business development manager, evaluating business opportunities and developing strategies with the Executive Director to ensure health plan success. Provides day to day ongoing provider contracting and provider relations, will monitor and track the provider network and work with UM to ensure that network needs are met, and will work with providers to ensure ongoing contracting where needs are identified.  Where issues are identified, will be responsible for resolution and follow up. Responsible for provider education, in conjunction with the Customer Service Manager to ensure that providers are adequately educated and knowledgeable about the health plan, including delivery and education of the Provider Manual.  Works closely with the Executive Director and Medical Director to identify new providers for network and obtain LOA's as needed to ensure member care is not affected.

Primary Responsibilities:

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  Identifies network needs through ongoing geo-access reporting, day to day interface with internal departments and other management team members


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  Develops and implements a plan of action to contract with additional providers to ensure an adequate network is maintained at all times


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  Ensures provider network is adequately trained and informed about the health plan, to include benefits and requirements of health plan, as well as compliance requirements; this includes development and implementation of  provider education and training including provider manual development and implementation


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  Conducts ongoing operational meetings, send communications and updates to providers as needed


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  Provides management reports on network, including access reports with analysis and plan of action, analysis and plan of action regarding provider satisfaction reports in conjunction with Customer Service


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  Works closely with Executive Director to evaluate operational processes and enhance business strategies to identify most effective operational processes and maximize success of the health plan


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  Perform all other duties as assigned

Required Qualifications:

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  Bachelor's degree in Business Administration or related field (HS Diploma/GED plus 8+ additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a Bachelor's degree)


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  5+ years of healthcare experience in healthcare contracting and/or provider relations including 2+ years in a leadership or supervisory capacity


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  Strong communication and negotiation skills


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  Healthcare contracting knowledge


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  Ability to do reporting, including use of computer programs such as excel, access


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  Ability and knowledge to analyze results of reporting and develop plan of action


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  Excellent presentation skills


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  Ability to do project management, adhering to a plan and timely outcomes

Preferred Qualifications:

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  Master's degree in Business Administration, Healthcare Administration or related field


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  Previous experience in managed care

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 90,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to 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. Certain positions are subject to random drug testing.

Job Keywords: Healthcare, Contracting, Account Manager, Negotiation, Business Development, Manager, Consultant, San Antonio, Dallas, Texas, TX