Dir, Network Administration - Edina, MN

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.



UnitedHealthcare, a UnitedHealth Group company, provides network-based health and well-being benefits and services for employers and consumers nationwide. We use our strength, diversity and innovation to improve the lives of the more than 18 million people who receive our unique products and services. And our endless pursuit for excellence in everything we do extends to your career as well. Join us today for an inspired and purposeful mix of professional growth opportunities and personal rewards.

 

This position is responsible for carrying out network related corporate business initiatives and projects including assisting in the development of strategic business goals and objectives, evaluating network composition and strategy, prioritizing network service activities and coordinating the network development activities for new site/service area expansions.

This position supports, validates and coordinates network expansion, re-mediation, and evaluation activities through project management, detailed and multi-faceted financial modeling, analysis, and reporting.  This position is responsible to ensure appropriate quantifying growth opportunities,  resources allocation, and realizes the targeted financial gain from network expansion efforts.  Establishes and maintains strong business relationships with various groups within UHG's commercial and government lines of business.  This position directly impacts financial performance and achievement of overall company goals. Executes national network strategies.

Collaborates with UHG businesses and UHN and other operational areas within Business Segment. This includes establishing and maintaining strong collaborative relationships with UHN leadership and regional Network Management leadership in which Business Segment has operations.
Has an active role in new site development and service area expansion in regard to: developing contract and reimbursement strategy, preparing counter-proposals and where appropriate or necessary assisting in negotiations.
Ensures Network Services compliance with all requirements relative to regulatory, and operational performance. This includes participation in development of standard contracts used to support business unit.
Monitor and influence claim resolution processes performed by network operations and UHN Network Data Management.
Assists in the development and coaching of the Network Services management team.
Oversees the SG&A budgets related to Network Expansion.
Establishes and maintains strong collaborative relationships with regional operations.



Bachelor's degree in business, health care management or related field, Master's Degree preferred.

Seven to ten years in a health care, network management, contracting and/or senior provider relations role.

Excellent knowledge of health care and insurance industry.

Strong negotiation skills; the ability to gain acceptance from others of a plan or idea and achieve a mutually beneficial outcome.

Ability to manage and prioritize multiple tasks, promote teamwork and fact based decision making.

Ability to develop and coach a management team.

Ability to manage, lead, and assist staff in multiple locations in a highly matrixed organization.

Ability to interpret and take action on trend reporting.

Ability to manage an administrative budget Ability to interpret and take action on trend reporting.

Knowledge of Medicare and other government program reimbursement methodologies (Resource Based Relative Value System, DRG, Groupers, etc.) for all provider types.

Ability to understand financial modeling and analysis used in making rate decisions.

In-depth knowledge of the contracting process, credentialing process, provider relations, and network data management/systems.

Problem solving skill; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action.

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 from others.


Diversity creates a healthier atmosphere: an equal opportunity employer, M/F/D/V