Network Account Manager - MD

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. 


 


Candidate can be located in Rockville, Baltimore, or Annapolis


 


Job Responsibilities:


Accountable for Physician network development and management activities in accordance with UnitedHealthcare standards and key process controls to achieve market/region/division/company objectives, including implementing network strategy and negotiating rates for Physicians.

Contribute to development of and successfully perform to geographic-specific unit cost targets.

Monitor respective geographic-specific unit cost performance and improve competitiveness, breadth and stability of Physician network.

Successfully implement geographic-specific unit cost improvement plans for Physician network.

Fill Physician network gaps at geographic-specific competitive rates in accordance with unit cost targets.

Ensure integrity of Physician network with UnitedHealthcare policies and compliance with pertinent regulatory guidelines.

Accountable for relevant components of provider relationship management, including provider outreach/communication.

Promote use of electronic provider on-line self-service tools in order to support and achieve operational efficiency.

Monitor activities related to contract load process, engage appropriate service organization for claims resolution, ARO, EDI, provider service/performance issues and provider appeals.

Maintain highest personal/professional integrity and enforce Principles of Integrity and Compliance.




Job Qualifications:


Three to five years in a network management/contract management role, such as contracting, provider services, purchasing, etc.

Bachelors degree in business, health care management, or related field preferred

Demonstrated effective negotiation skills and implementation/influencing skills.

Ability to utilize and interpret financial models and network adequacy analyses.

Strong knowledge of RBRVS reimbursement methodology and clear understanding of claims processing guidelines.

Problem solving skills, including the ability to systematically analyze complex problems, draw relevant conclusions, and successfully devise/implement appropriate solutions calmly.

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.

Proficient in speaking in both individual and group settings.

Ability to multi-task, shifting back and forth effectively among multiple activities.

Possesses good interpersonal skills, establishing rapport and working well with others.


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