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Associate Director, Network Programs - Overland Park, KS
at UnitedHealth Group
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 Director of Network Programs is responsible for the successful program design, compliance with network requirements, network assessment and selection, provider customer satisfaction and program implementations in support of the Health Plan’s provider network operations strategy. Working for a leading edge and innovative health plan, works on front lines transforming health care to better serve our member customers and provide for the highest provider satisfaction. Strong focus on Home and Community Based Care and Nursing Facility services. Leads and support Medicaid Health Plan’s network strategy for all provider networks. Performs 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.
- Own end -to - end processes for the health plan
- Participates with the senior leadership team and shared services partners, contributing to formulating strategies that improve the quality of our networks and associated support systems and processes
- Leads a team of top notch and high performing provider advocate associates
- Develops functional, market level, and / or site strategy, plans, production and/or organizational priorities
- Identifies and resolves technical, operational and organizational problems outside own team
- Interfaces with providers, associations and State agencies on a regular basis, via email, phone and in - person
- Undergraduate degree or 5 years of equivalent experience
- 5+ 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
- 5+ years of experience managing staff
- 3+ years of 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
- Advanced proficiency in MS Office (Excel, Access and PowerPoint)
- Ability to work with various internal business partners, leading and driving operational performance
- Strong communications skills, written and verbal, as well as strong relationship building capabilities
- Present information to senior leaders, both internal and external to UHC
- Vendor management and support
- Ability to develop presentations and collateral to support provider network
- Flexibility to travel to provider offices and attend meetings with various stakeholders across Kansas
- Prior leadership skills coaching and developing employees to peak performance
- Good strategic abilities, including developing strategic business plans, in collaboration with other health plan leaders
- Excellent communication skills, including ability to communicate effectively with various levels of leadership
- Ability to convey complex or technical information in a manner that others can understand
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: 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: managed care, network management, contract management, data analysis, project management, claims systems, Overland Park, KS, Kansas