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MSLA - Provider Network Manager - Cypress, CA

UnitedHealth Group


Location:
Cypress, CA
Date:
08/18/2017
2017-08-182017-09-16
Job Code:
1759527
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Job Details


MSLA - Provider Network Manager - Cypress, CA(Job Number:719792)
Description

MSLA is a Medical Corporation that provides comprehensive independent medical evaluations (IME) and other IME related services to the government and private industry. Our business philosophy incorporates both exceptional customer service and quality evaluations, both of which are the primary factors for our rapid growth since our inception in 1998. No industry is moving faster than health care. And no organization is better positioned to lead health care forward. We need attention to every detail with an eye for the points no one has considered. The rewards for performance are significant. You'll help improve the health of millions. And you'll do your life's best work.(sm)

 

The Provider Network Manager manages and directs the administrative functions relating to contracted providers, including physician recruitment, network strategy development, negotiations, contract drafting, credentialing, contract monitoring, establishing and improving provider relationships, optimizing provider utilization and overall provider communications. Additionally, responsible for coordinating subordinate employee recruitment, selection and training, performance assessment, work assignments, salary, and recognition and disciplining process.

 

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
  • Direct the implementation of provider contracts. Develop systems, policies and procedures to communicate and ensure a successful contracts implementation
  • Ensure appropriate provider network composition to meet customer needs
  • Manage contract compliance. Develop systems and procedures to ensure the collection of credentialing information. Ensure accreditation and other regulatory requirements are met and are in adherence to business line contracts
  • Develop and implement effective provider recruitment and orientation programs
  • Manage the recruitment, credentialing, provider relations and provider liaison functions with direct oversight of provider credentialing and management of provider database
  • Negotiation of new and existing contracts where additional support is needed
  • Work with the Executive Team to ensure pay schedules remain competitive
  • Works closely with operational managers to identify provider problems / complaints and develops and implements a course of action to resolve concerns
  • Lead efforts on new developments or modifications of provider database or applications
  • Contract management including negotiation, implementation and enforcement of contracts with service providers including physicians, allied health professionals, laboratory, radiology and other diagnostic providers

Job Provider Contracting & Network Development
Primary Location US-CA-Cypress
Other Location 
Organization Logistics Health Inc
Schedule Full-time
Number of Openings 1
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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