The job below is no longer available.
You might also like
in Houston, TX
- $58,000.00 - $68,200.00
Verified per year Scotts Miracle Gro • 4d agoUrgently hiring 0.1 mi Use left and right arrow keys to navigate - $15 - $19.50
Verified per hour Macys • 27d agoGood pay Urgently hiring 6.4 mi Use left and right arrow keys to navigate - $30
est. per hour Five Below • 12d agoUrgently hiring 11.6 mi Use left and right arrow keys to navigate - $17
est. per hour Five Below • 4d agoUrgently hiring 11.9 mi Use left and right arrow keys to navigate 
$28est. per hour SYSCO • 3h agoJust posted Urgently hiring Use left and right arrow keys to navigate
Senior Network Account Manager - Houston, TX
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Houston, TX Houston, Texas |
About this job
Position Description:
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)
Primary Responsibilities:
- Develops and
maintains the physician provider network yielding a geographically competitive,
broad access, stable network for commercial and government products (including
Medicare, Medicaid and CHIP) that achieves objectives for unit cost performance
and trend management, and produces an affordable and predictable product for
customers and business partners. - Evaluates and negotiates contracts in
compliance with company contract templates, reimbursement structure standards,
performance programs, and other key process controls. - Establishes and maintains
strong business relationships with providers, and ensures the network
composition includes an appropriate distribution of provider specialties. - Analyzes and investigates.
- Provides explanations and interpretations within
area of expertise. - Assess
and interpret customer needs and requirements. - Identify solutions to non-standard requests and problems.
- Solve moderately complex problems and/or conduct moderately complex analyses.
- Work with minimal guidance; seek guidance on only the most complex tasks.
- Translate concepts into practice.
- Provide explanations and information to others on difficult issues.
- Coach, provide feedback, and guide others.
- Act as a resource for others with less experience.
Requirements
Required Qualifications:
- Bachelor's Degree.
- 4+ years of experience with Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS).
- 3+ years of experience in fee schedule development using actuarial models.
- 3+ years of experience utilizing Financial models and Analysis in negotiating rates with providers.
- 2+ years of experience with Claims service and systems processing and guidelines.
- 3+ years of experience in performing network adequacy analysis.
- Ability to learn and/or use various technology systems.
- Ability to negotiate complex contracts with external parties.
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.