Network Program Manager - St. Louis or Kansas City, MO

UHG St. Louis, MO

About the Job

We all agree that health care can perform better if we continue to challenge the status quo. Right? That's why people like you and organizations like UnitedHealth Group are driving ever higher levels of sophistication in how provider networks are composed and compensated. Your expertise in provider networks can help us build in the next phase of evolution. In this managerial role, you'll use your knowledge and analytical skills to help determine how clinical providers group up by specialty and service line. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 5 leader.

  

Primary Responsibilities:

  • Set team direction, resolve problems, and provide guidance to members of own team
  • Adapt departmental plans and priorities to address business and operational challenges
  • Direct cross-functional and/or cross-segment teams to develop enterprise-wide Clinically Integrated Networks focused on specific clinical areas/service lines such as oncology or cardiology
  • Oversee network analysis and strategy development and implementation
  • Drive program design and implementation to improve quality and affordability through improvements in appropriateness and effectiveness
  • Ensure teams are obtaining, validating, and analyzing data impacting network availability and access 

Set team direction, resolve problems, and provide guidance to members of own team

It's time to raise your game. This is a fast-paced, intense and performance focused environment where you'll interact frequently with our field teams and with providers to ensure quality of network performance.


Required Qualifications:

  • Undergraduate degree or equivalent work experience
  • 5+ years of experience working with a managed care organization or health insurer, or as a consultant in a network/contract management role, such as contracting, provider services, etc.
  • 5+ years of experience in data analysis
  • 3+ years of experience managing staff and/or at least 3 years of project management or project lead experience
  • Proficiency with all facility/ancillary contract reimbursement methodologies
  • 5+ years of experience with claims systems
  • 3+ years of experience with contract submission, validation, and maintenance with strong knowledge of business processes that impact facility/ancillary contact loading and auditing

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world?s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity 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, health care, network requirements, network assessment, network selection, network data management, provider data analysis, medical claims, claims processing, claims resolution, medical coding, project management, management, leadership, St Louis, Kansas City, MO, Missouri