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Network Contract Manager, WellMed - Dallas, Fort Worth, TX

Posted on Feb 14, 2020 by UnitedHealth Group

Fort Worth, TX 76101
Admin & Secretarial
Immediate Start
Annual Salary

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created 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)

We are seeking a Network Contract Manager for growth and expansion in the Texas market, which will include new development and current ongoing development efforts. Network Contract Managers develop 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. They 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.

Primary Responsibilities:

  • 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, provide feedback, and guide others

  • Act as a resource for others with less experience

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.

Required Qualifications:

  • Bachelor's degree or equivalent experience
  • 2+ years of experience in a network management-related role, such as contracting or provider services

  • 2+ years of experience utilizing financial models and analysis in negotiating rates with providers

  • 2+ years of experience in performing network adequacy analysis

  • Access to reliable transportation and ability to travel 90% when expanding new markets; overnight stays may also be required

Preferred Qualifications:

  • In-depth knowledge of Medicare reimbursement methodologies, ie Resource Based Relative Value System (RBRVS)

  • Knowledge of claims processing systems and guidelines

  • Excellent communication and interpersonal skills

  • Strong customer service skills

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 380,000+ 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)

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: healthcare, health care, Medicare, contracting, network contract manager, network management, contract negotiation, network development, provider services, WellMed, Dallas, Fort Worth, TX, Texas

Reference: 844684414

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