Associate Director of Network Programs - Overland Park, KS - 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 Associate Director of Network Programs is responsible for the successful program design, compliance with network requirements, network assessment and selection, and program/product implementation.  Focus of the role is on Home and Community Based Services, supporting consumers with long term care and community service needs.  Develops both strategic and tactical plans for organization, and drives delivery of those plans, to improve the provider experience, along with improving provider and consumer satisfaction and exceeding expectations consistently.  Drives performance of all team members.  Associate Directors of Network Programs 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. Primary Responsibilities:

Assess, evaluate and implement programs and initiatives that support the health plan’s strategic roadmap
Develop functional, market level, and/or site strategy, plans, production and/or organizational priorities
Identify and resolve technical, operational and organizational problems outside own team
Take the lead for health plan in supporting regulatory audits as applying to network management and other State deliverables
Lead a team of provider advocates and other health plan staff, including direct supervision and skip level support and leadership, including driving high levels of employee engagement and development
Effectively build relationships with key internal and external business partners, stakeholders, associations and customers,  leading and driving operational performance
Demonstrate strong communications skills, both written and verbal, and ability to put together audience-specific presentations materials and information, including training for providers
Proactive and engaged leadership for the health plan
Work with cross functional teams on a number of high priority, innovative and complex projects and initiatives
Develop innovative programs, processes and policies, and contribute to organizational culture that enables other employees, including those within the reporting hierarchy, to do the same
Travel to Topeka to attend meetings with State Regulatory agency, provider associations and others, as needed
Exercise leadership skills coaching and developing employees to peak performance
Demonstrate strategic abilities, including developing strategic business plans, in collaboration with other health plan leaders

Required Qualifications:

Undergraduate degree or equivalent work experience
5+ years’ experience working with a managed care organization, health insurer, or consultant in a network management/contract management role, such as contracting, provider services, etc.
5+ years’ experience in data analysis
5+ years’ experience managing staff
3+ years project management or project lead experience
Intermediate level of proficiency with all facility/ancillary contract reimbursement methodologies
5+ years’ experience with claims systems
Strong knowledge of business processes that impact facility/ancillary contact loading and auditing
3+ years’ experience with contract submission, validation and maintenance
Ability to convey complex or technical information in a manner that others can understand
Excellent communication skills, including ability to communicate effectively with various levels of leadership
Advanced proficiency in MS Office (Excel, Word and PowerPoint)
Flexibility to travel to provider offices and attend meetings with various stakeholders across Kansas at least 25% of the time
Reside in the state of Kansas
Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place 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.
 
Job Keywords: 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, Supervisor, Manager, Director, Overland Park, Wichita, Topeka, Kansas, KS