Network Program Manager - Telecommute within USA - 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 Manager is responsible for the successful program design, compliance with network requirements, 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 to improve the quality and affordability through improvements in appropriateness and effectiveness. Network Program Managers may perform network analysis,  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 specific role supports Group Retiree as SME for network changes; ie. large scale terminations, additions, and network advisory reports. The role works with network advisory reports to identify access needs and potential compliance issues. The role works closely with the local markets to ensure network information is communicated in both directions. The role will research provider network solutions when access gaps are identified, and work with the local market to close those access gaps.
 
In this role you will be expected to:- Predict emerging customer needs and develop innovative solutions to meet them- Solve unique and complex problems with broad impact on the business- Lead large, complex projects to achieve key business objectives
- May have segment wide impact- Translate highly complex concepts in ways that can be understood by a variety of audiences- Influence senior leadership to adopt new ideas, products, and/or approaches- Direct cross-functional and/or cross-segment teams

Requirements:
- 7+ 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.
- Expert level of proficiency with all physician/facility/ancillary contract reimbursement methodologies
- 4+ years experience with data analysis
- 2+ years project management or project lead experience
- 2+ years experience presenting data to audiences (diverse levels)

 
Assets:
- 2+ years experience working with claims systems- 3+ years experience with facility/ancillary contact loading and auditing including contract submission, validation and maintenance
- Previous experience with Network Advisory reports
- Previous role working with member access and compliance with state regulations relative to member access
- Previous experience with the BARTRACK system- Ability to convey complex or technical information effectively
- Excellent communication skills, including with various levels of leadership- Intermediate level of proficiency in MS Office
- Undergraduate or higher level degree
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and 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 Development,Member Access,  Network Advisory Reports, Network Liaison, Telecommute, Tele, Work at home
 
 
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