Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)
So where are we today? The public and health care community are focused on the scope, diversity and quality of provider networks associated with health care products and coverage. People like you and organizations like UnitedHealth Group are driving ever higher levels of sophistication in how provider networks are composed and compensated. That means everything is open to new ideas and innovation. And 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 6 leader opportunities that you’d expect from a Fortune 5 leader.
- 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
This is an opportunity that will offer you challenge like no other. We operate a complex, matrixed business that requires you to work through ambiguity even as you build a relationship with some of our most focused and intense business leaders. You'll need to conceptualize effectively, communicate clearly and earn credibility within a demanding business environment.
You’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.
- 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
- 5+ years of experience managing staff and 3+ years of project management or project lead experience
- 5+ years of experience with claims systems
- 3+ years of experience with contract submission, validation and maintenance with solid knowledge of business processes that impact facility/ancillary contact loading and auditing
- Proficiency with all facility/ancillary contract reimbursement methodologies
- Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance
UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.
Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)
WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: Associate Director, Network Programs, Houston, TX, Texas, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote