The job below is no longer available.
You might also like
in Cypress, CA
- U.S. Navy • 30d ago
Urgently hiring 2.2 mi Use left and right arrow keys to navigate - $30
est. per hour United Pacific • 9d agoUrgently hiring 2.5 mi Use left and right arrow keys to navigate 
$23est. per hour Redwood Family Care Network • 5h agoUrgently hiring 6.5 mi Use left and right arrow keys to navigate- $17.00 - $18.50
Verified per hour Redwood Family Care Network • 5h agoUrgently hiring 9.9 mi Use left and right arrow keys to navigate
Network Contract Manager - Cypress, CA - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Cypress, CA Cypress, California |
About this job
Position Description:
UnitedHealth
Group is working to create the Healthcare system of
tomorrow and you can help. Already Fortune 17, we are totally focused on
innovation and change. We work a little
harder. We aim a little higher. We expect more from ourselves and each other.
And at the end of the day, we're doing a lot of good.
Through our family of businesses and a lot of inspired individuals, we're
building a high-performance Healthcare system that works better for more people
in more ways than ever. Now we're looking to reinforce our team with people who
are decisive, brilliant and built for speed.
Join with us and start doing your life's best work.SM
The Network Contract Manager develops the provider network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.) yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners. Network Contract Managers evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties.
Primary Responsibilities:
- 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 OR High School Diploma/GED plus 5+ years of experience in a Network Management-related role, such as contracting or provider services.
- Comfortable traveling a couple times per month as needed
- 4+ years of experience in a Network Management-related role, such as contracting or provider services
- 3+ years of experience in performing Network Adequacy Analysis.
- 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.
- 3+ years of experience working with capitated medical groups and hospitals especially pertaining to contract negotiations.
- Understanding of capitation payment methodologies and regulatory guidelines pertaining to California risk bearing organizations "RBOs".
- Proficient using a computer and Microsoft Office (MS Word, MS Excel, MS Outlook, MS PowerPoint).
Preferred Qualifications:
- Knowledge of Claims Processing Systems and guidelines.
- Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS).
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.
Your Privacy Choices