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Hours Full-time, Part-time
Location Cypress, CA
Cypress, California

About this job

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 Senior 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. Senior 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:

Anticipate customer needs and proactively develop solutions to meet them
Serve as a key resource on complex and / or critical issues
Solve complex problems and develop innovative solutions
Perform complex conceptual analyses
Review work performed by others and provide recommendations for improvement
Forecast and plan resource requirements
Authorize deviations from standards
May lead functional or segment teams or projects
Provide explanations and information to others on the most complex issues
Motivate and inspire other team members.
This role is accountable to support the entire CA team as it relates to the initiatives for all lines of business in the market.
This role is a statewide CA Network Management role working on the Statewide Quality and consistencies team managing:

The CA Contract Playbook Initiative
Contract Committee Meetings
CA Contract projects
CA Statewide contracting initiatives
CA Regulatory Implementations
CA Product Implementations
CA Contract liaison for National

Requirements


Required Qualifications


Undergraduate degree or equivalent experience

5+ years of experience in a network management-related role handling complex network providers with accountability for business results

5+ years of experience in the health care space

Working capitation knowledge 

Knowledge of Medicare reimbursement methodologies such as Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.

Strong customer service skills

Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information form others, including but not limited to reimbursement policy standards

Strong interpersonal skills, establishing rapport and working well with others

Must live within a commutable distance to the Cypress, CA office
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: 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: senior, network contract, manager, network management, RBRVS, telecommute, Cypress, CA, California