Network Program Manager - Draper, UT
Company: UnitedHealth Group
Location: Draper
Posted on: June 19, 2022
Job Description:
Combine two of the fastest-growing fields on the planet with a
culture of performance, collaboration and opportunity and this is
what you get. Leading edge technology in an industry that is
improving the lives of millions. Here, innovation is not about
another gadget; it is about making health care data available
wherever and whenever people need it, safely and reliably. There is
no room for error. If you are looking for a better place to use
your passion and your desire to drive change, this is the place to
be. It's an opportunity to do your life's best work.(sm)The more
you do, the more you learn. And as you learn you find new doors
opening that challenge you to bring your best. This specialist role
with UnitedHealth Group will call on your knowledge, your energy
and your commitment to making health care work more effectively for
more people. We're 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. -The Provider Network Program Manager with
OptumCare is responsible for developing, maintaining, and servicing
a high quality, marketable and satisfied provider network within an
assigned geographic area. Key responsibilities include recruitment
and contracting, education, and servicing of assigned providers.
The Provider Network Program Manager helps assigned providers
operate successfully within our healthcare delivery model by
providing strategic planning and tools to meet goals. This position
is expected to build and sustain strong working relationships with
cross-functional departments, vendors, local sales, and assigned
providers. The Provider Network Program Manager is accountable for
overall performance and profitability for their assigned groups, as
well as ownership and oversight to provide redirection as
appropriate.Primary Responsibilities:
- Educate providers to ensure that they have the tools they need
to meet quality, risk adjustment, growth (as appropriate), and
total medical cost goals per business development plans facilitated
through strategic meetings
- Ensure providers have in-depth understanding of OptumCare model
to include, but not limited to, patient care best practices,
contractual obligations and program incentives
- Conduct detailed analysis of various reports by tracking data
to develop a strategic plan to ensure performance goals are
achieved
- Ensure the overall strategic plan incorporates interventions
with internal departments including Medical Directors, Clinical
Educators/Coders, Quality/HEDIS nurses, pharmacists and others as
needed
- Collaborate with Medical Director to monitor utilization trends
and profit pools and share results with assigned PCPs and/or
Specialists
- Conduct new provider orientations and ongoing education to
providers and their staffs on OptumCare programs, processes and
compensation arrangements
- Maintain open communication with providers to include issue
resolution on health plan issues related to credentialing, claims,
eligibility, disease management, utilization management, quality,
and risk adjustment program.
- Collaborate with provider groups to develop, execute, and
monitor performance and patient outcomes improvement plans
- Handle or ensure appropriate scheduling, agenda, materials,
location, meals, and minutes of provider meetings as needed
- Collaborate with contracting team to ensure provider data is
correct and provider directories include any needed updates
- Represent OptumCare by coordinating company sponsored provider
events (summits, learning sessions)
- Regularly meet with cross-functional team to create, revise,
and adjust strategy for assigned provider groups to meet overall
performance goals
- Introduce and advocate company resources to facilitate practice
optimizationYou'll be rewarded and recognized for your performance
in an environment that will challenge you and give you clear
direction on what it takes to succeed in your role as well as
provide development for other roles you may be interested
in.Required Qualifications:
- 1+ years experience in data analytics
- Demonstrated experience with making presentations to both small
and large groups
- Access to reliable transportation and ability to travel up to
75% within Northern Utah
- Ability to work evenings and weekends on occasion based on
business needs
- Intermediate proficiency with MS Suite (including Word,
PowerPoint, and Excel)
- You will be asked to perform this role in an office setting or
other company location
- Full COVID-19 vaccination is an essential job function of this
role. Candidates located in states that mandate COVID-19 booster
doses must also comply with those state requirements. UnitedHealth
Group will adhere to all federal, state and local regulations as
well as all client requirements and will obtain necessary proof of
vaccination, and boosters when applicable, prior to employment to
ensure compliance. Candidates must be able to perform all essential
job functions with or without reasonable accommodationPreferred
Qualifications:
- Bachelor's Degree or equivalent work experience
- act management role, such as contracting, provider services,
etc
- 2+ years project management or project lead experience
- 3+ years -working with a managed care organization or health
insurer; or as a consultant in a network/contr
- 2+ years of -experience working with claims systems
- 2+ years of experience with facility/ancillary contracts
- Expertise in physician/facility/ancillary contract
reimbursement methodologies
- Understanding of medical financial statements and delivery
systems, provider contracting, reimbursement arrangements, and
network management
- Established knowledge of local provider community
- Exceptional interpersonal skills with ability to interface
effectively both internally and externally with a wide range of
people including physicians, office staff, hospital executives, and
other health plan staff
- Ability to manage multiple priorities and maintain an organized
approach
- Create business strategies through excellent analytical and
problem solving skills with effective follow throughTo protect the
health and safety of our workforce, patients and communities we
serve, UnitedHealth Group and its affiliate companies require all
employees to disclose COVID-19 vaccination status prior to
beginning employment. In addition, some roles and locations require
full COVID-19 vaccination, including boosters, as an essential job
function. UnitedHealth Group adheres to all federal, state and
local COVID-19 vaccination regulations as well as all client
COVID-19 vaccination requirements and will obtain the necessary
information from candidates prior to employment to ensure
compliance. Candidates must be able to perform all essential job
functions with or without reasonable accommodation. Failure to meet
the vaccination requirement may result in rescission of an
employment offer or termination of employmentCareers 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. - -
-
Keywords: UnitedHealth Group, Draper , Network Program Manager - Draper, UT, Executive , Draper, Utah
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