Network Program Manager - Home and Community Based Services

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 needs of specialty populations to improve the quality and affordability through improvements in appropriateness and effectiveness. Network Program Managers 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 specialty networks for Complex care Products and focus on not only traditional providers but community providers.

Primary Responsibilities:

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  Predict emerging customer needs and develop innovative solutions to meet them



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  Solve unique and complex problems with broad impact on the business



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  Participate in the development of business strategy



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  Develop and manage business plans to achieve objectives



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  Lead large, complex projects to achieve key business objectives



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  Translate highly complex concepts in ways that can be understood by a variety of audiences



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  Influence senior leadership to adopt new ideas, products, and/or approaches



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  May have segment-wide impact



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  Direct cross-functional and/or cross-segment teams

Required Qualifications:

• Undergraduate degree


• 10+ years of 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 of experience in data analysis


• 2+ years of project management or project lead experience


• Expert level of proficiency with all physician/facility/ancillary contract reimbursement methodologies


• 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


• Expert level of proficiency in MS Office (Excel, Access and PowerPoint)

Preferred Qualifications:

• Post-graduate degree


• 2+ years of experience working with claims systems


• 3+ years of experience with facility/ancillary contact loading and auditing including contract submission, validation and maintenance

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: program manager, data analysis, analytics, project management, telecommute, telecommuter, Minnetonka, Minnesota, MN