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About UHG

Careers at UnitedHealth Group

 

We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Network Management

Country:

US

Approximate Salary:

Not Specified

Position Type:

Full Time

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Network Manager - Telecommute in Tucson, AZ

UHG - Tucson, Arizona

Posted: 12/7/2018

There comes a point when you're ready to take off the training wheels and start guiding others. If that's where you are today, let's talk about where you can be tomorrow with our leading, global health care organization. UnitedHealth Group is driving ever higher levels of sophistication in how provider networks are composed and compensated. Everything is open to new ideas and innovation. Here's where you come in. Your expertise in provider networks can help us build in the next phase of evolution. In this 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.

 

The Senior Network Program Specialist is responsible for the successful program design, compliance with network requirements, network assessment and selection, and program / product implementation. This includes enterprise - wide clinically integrated network programs or initiatives, to improve the quality and affordability through improvements in appropriateness and effectiveness. Senior Network Program Specialists may perform network analysis and strategy development and implementation; obtain data, verify validity of data, and analyze data as required, and analyze network availability and access. Other responsibilities may also include making recommendations regarding use, expansion, selection of networks for various products based on that analysis.
 

If you are located in Tucson, Arizona, you will have the flexibility to telecommute* as you take on some tough challenges.

 
Primary Responsibilities:
  • Responsible for a wide range of activities pertaining to strategic planning and analysis, medical data analysis (RAF), disease management, chronic care models, and STARs / HEDIS quality interactions
  • Educates PCPs and their staff members on health plan products and processes, develops project plans which identify key issues, problems, approaches, performance metrics and resources required and provides staff leadership to multi - disciplinary teams. Serves as a liaison between provider and OptumCare
  • Maintain and obtain contracts within assigned territory
  • 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 and provide feedback to assigned PCP practices on OptumCare processes
  • Act as a resource for others with new staff or others with less experience

Required Qualifications:
  • Undergraduate degree, or job experience equivalent
  • 3+ years of experience with network data management in a managed care environment
  • Intermediate proficiency in MS Office (Excel, Access and PowerPoint)
Preferred Qualifications:
  • 1+ years of Medicare Advantage experience, risk adjustment, HEDIS, and working closely with providers in these areas
  • 3+ years of experience with claims processing systems and provider databases
  • 3+ years of experience in provider data analysis and communicating metrics
  • Proven ability to work closely with providers to meet OptumCare policies and procedures
  • Ability to convey complex information to others and make it more easily understood
  • Ability to prioritize multiple tasks in an environment of rapid change
  • Excellent communication skills, including ability to communicate effectively with various levels of leadership

 

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

 

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

 

 

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.

 

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

 

Job Keywords: Network management, risk adjustment, telecommute, telecommuter, work from home, Tucson, AZ, Arizona

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