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Job Details


UnitedHealth Group

Network Program Manager - Las Vegas, NV

Healthcare

Nurse Manager

Yearly

No

Las Vegas, Nevada, United States

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

The Network Program Manager is responsible for value-based payor strategy innovation, including value-based contracting, performance improvement, population health infrastructure implementation, outcomes, and other strategies while continuously improving quality and access. They will serve as liaison between the health plan and practice to develop, communicate and execute value-based strategic direction. They will research and remain informed with industry and market trends on best prices and initiatives in developing new and innovative payment and network models that support quality-driven health care. They will also build and manage internal and external relationships, coordinates departmental strategy and policy development, and evaluate key contracting methodologies and operational goals/targets.

Primary Responsibilities:

  • Manages value-based payor strategy innovation including value-based contracting, performance improvement, population health infrastructure implementation, and other contracting strategies while continuously improving quality and access
  • Serves as liaison between the practice and health plans to develop, communicate and execute value-based strategic direction
  • Stays informed with industry and market trends on best prices and initiatives in developing new and innovative payment and network models that support quality-driven health care
  • Performs network analysis to identify potential provider recruitment opportunities
  • Works with Network Contract Managers and Network Contractors to maintain and strengthen provider relationships
  • Communicates provider network outcomes to leadership
  • Help providers understand and improve performance under incentive contracts and accountable care strategies
  • Acts as a Subject Matter Expert (SME) and resource for other peers


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:

  • 4+ years of experience in a network management-related role, such as contracting or provider services
  • 4+ years provider contract negotiating, writing and implementation experience
  • 4+ years of experience in fee schedule development using actuarial models
  • 4+ years of experience using financial models and analysis to negotiate rates with providers
  • 4+ years of experience in performing network adequacy analysis
  • Intermediate level of knowledge of claims processing systems and guidelines
  • In-depth knowledge of Medicaid and Medicare reimbursement methodologies
  • Proficiency in Microsoft Excel, Word, Access, and PowerPoint
  • Ability totravel regionally 50% - 75%
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifcation:

  • Solid written, oral and organizational skills

Competencies and Best Practice for High Performers:

  • Communication
    • Demonstrates effective written and oral communication skills
    • Communicates clearly
  • Teamwork
    • Collaborates with colleagues
    • Builds productive working relationships
  • Quality Improvement
    • Understands the value of innovation and quality improvement
    • Improves processes and practices by identifying inefficiencies and redundancies


To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)

Nevada Residents Only: The salary range for Nevada residents is $90,500 to $161,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.


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.

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