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Network Contract Manager, National Retiree PPO - Midwest
| Hours | Full-time, Part-time |
|---|---|
| Location | Overland Park, KS Overland Park, Kansas |
About this job
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)
This Network Contract Manager is part of a national team responsible for successful design and implementation of the network in support of the National Retiree PPO product. The position will be part of team charged with driving STARS improvement among non-par providers.
Person selected for this role should have understanding of provider contracting, especially for Medicare, and have knowledge of STARS and incentive programs that UHN has in place to support STAR improvement. Especially helpful is knowledge of Group Retiree products such as NPPO.
- Assess and interpret customer needs and requirements
- Identify solutions to non-standard requests and problems
- Analyze, report and manage data to support the initiative of the national team
- Work with minimal guidance; seek guidance on only the most complex tasks
- Provide explanations and information to others on difficult issues
- Work with the new strategy team to track initiatives, especially HEDIS measures, to improve the quality and affordability of care
- Act as a resource for others with less experience
- Travel as needed
Requirements
Required Qualifications:
- 4+ years experience with a managed care organization, health insurer, or consultant in a network management/contract management role, such as contracting, provider services, etc.
- 4+ years experience with data analysis
- 2+ years project management or project lead experience
- 2+ years presentation experience
- At least an intermediate level of proficiency with MS Excel and PowerPoint
Desired Qualifications:
- Knowledge of Medicare contracting, Stars-HEDIS, and PPO product designs
- 3+ years of experience utilizing financial models and analysis in negotiating rates with providers
- At least an intermediate level of knowledge of claims processing systems and guidelines
- 3+ years of experience in performing network adequacy analysis
- In-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)
- Strong negotiation and analytical skills
- Excellent communication skills
- Strong interpersonal skills
- Strong customer service skills
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: Healthcare, Contracting, Account Manager, Negotiation, Business Development, Manager, Consultant, Midwest
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