Senior Healthcare Network Contract Manager - Iselin, NJ
Location: Iselin New Jersey
Description: UnitedHealth Group is employing Senior Healthcare Network Contract Manager - Iselin, NJ right now, this vacancy will be placed in New Jersey. Further informations about this vacancy opportunity kindly see the descriptions. Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are creat! ed 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 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: - An! ticipate customer needs and proactively develop solutions to m! eet 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.
This person will be responsible for contracting with Tier 2 and Tier 3 Hospitals in the New Jersey market and managing and supporting many processes related to the Hospital Contracting function. Some examples are Chargemaster management, Amendment Drafting and contract auditing to name a few. This person will need to work with financial models and understand and work within financial targets and budgets.
Develops the provider network (physicians, hospitals, pharmacies, ancillary gr! oups & 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. Evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Establishes and maintains strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties.- Reviews the work of others.- Develops innovative approaches.- Sought out as expert.- Serves as a leader/ mentor.
Requirements: - Undergraduate degree or equivalent experience.- 5+ years of experience in a network management-related role handling complex network providers with accountability for business results.- 5+ years of experience in the health care in! dustry.- Expert level of knowledge of Medicare reimbursement methodologi! es such as Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.- 2+ years of 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.
UnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus: UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, ! affordable benefits services.UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.Together, we’re removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being.Come grow and thrive in our culture of innovation and ideas. Be! cause there is no opportunity greater than the quest to help people liv! e healthier lives.
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If you were eligible to this vacancy, please email us your resume, with salary requirements and a resume to UnitedHealth Group.
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This vacancy starts available on: Thu, 25 Apr 2013 05:47:57 GMT
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