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Network Contract Manager - Ontario, CA

UnitedHealth Group


Location:
Ontario, CA
Date:
08/18/2017
2017-08-182017-09-16
Job Code:
1755029
Apply on the Company Site
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Job Details


Network Contract Manager - Ontario, CA(Job Number:717751)
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 life's best work.(sm)

 

The 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. 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.

 

Primary Responsibilities:

  • Assess and interpret customer needs and requirements
  • Identify solutions to non-standard requests and problems
  • Solve moderately complex problems and/or conduct moderately complex analyses
  • Work with minimal guidance; seek guidance on only the most complex tasks
  • Translate concepts into practice
  • Provide explanations and information to others on difficult issues
  • Coach, provide feedback, and guide others
  • Act as a resource for others with less experience

In addition, the Manager of Provider/Network Contracting acts in the role of contracting resource for our internal Department Managers as well as our Executive Directors and Provider Service Representatives. All resources on the team are fully utilized in their current positions therefore there is no position on the team that we can consolidate/absorb this position into. Other impacts include, driving of vital signs, risk of on time and quality delivery of amendments/agreements, turnaround times impact Transactional Services and Medical Management causing delays or incorrect claims payments, claims sent to incorrect addresses and provider information correctly appearing in our referral system. In addition to the delayed turnaround, the potential of impact to our NPS scores due to Provider dissatisfaction due to delay in changes of their Agreements.

 

Additional responsibilities/functions of the Manager of Provider/Network Contracting:

  • Attend meetings and Joint Operation Meetings with our Provider/Vendors
  • Oversight of maintenance of original contract documents and departmental workflows
  • Reviews contracts for accuracy and proposes revisions as needed
  • Oversight of special projects
  • 3-5 years equivalent experience in a healthcare related field
  • Management experience of contracting processes from prep, negotiation & implementation and ability to understand contract structure (ie: risk, financial impact)
  • Excel, Power Point, Work, Outlook
  • General understanding of the healthcare industry and/or local physicians market
  • Skill in organizing, prioritizing goals and responsibilities

Job Provider Contracting & Network Development
Primary Location US-CA-Ontario
Other Location 
Organization NAMM California
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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