Senior Network Contract Manager - Overland Park, KS at Overland Park

Description:

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 lifes 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. In this role you will be expected to:- 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.

Qualifications:

Requirements:
- Prior experience with Medicaid and TriCare programs a plus.- Undergraduate degree or equivalent experience.- 5+ years experience in a network management-related role handling complex network providers with accountability for business results.- 5+ years experience in the health care industry.- 2+ years experience in contributing to the development of product pricing and utilizing financial modeling in making rate decisions- Expert level of knowledge of Medicare reimbursement methodologies such as Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.- 2+ years experience with provider contracting.- 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.
Country: USA, State: Kansas, City: Overland Park, Company: UnitedHealth Group.