Senior Network Programs Specialist
Company: UnitedHealth Group
Location: San Jose
Posted on: June 26, 2022
Job Description:
Combine two of the fastest-growing fields on the planet with a
culture of performance, collaboration and opportunity and this is
what you get. Leading edge technology in an industry that's
improving the lives of millions. Here, innovation isn't about
another gadget, it's about making health care data available
wherever and whenever people need it, safely and reliably. There's
no room for error. Join us and start doing your life's best
work.(sm) You'll enjoy the flexibility to telecommute* from
anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Assess and interpret customer-defined network needs and
requirements
- Analyze network data to in compliance with requirement
standards and other key process controls
- Identify provider network gaps and develop process to document,
track and share these with appropriate team members
- Assist provider network leadership to develop strategies and
document each strategy along with timeline for remediation to meet
contractual obligations to the customer
- Document implementation of new large network provider groups
and strategies that are intended to increase provider network
access and improve objectives for performance
- Ensure that provider network composition includes an
appropriate distribution of provider specialties and communicate
gaps in specialties to provider network contracting leadership and
team
- Ensure that provider gaps filled through contracting are
tracked through credentialing and training processes to create
timely follow up when needed
- Create and maintain relationships with program leadership,
dedicated/contracted network teams and operational groups as the
primary point of contact for matters concerning network adequacy
and other assigned areas of focus
- Communicate and present information to identified stakeholders
about all network adequacy related matters, as requested
- Develop solutions to non-standard requests and problems
- Solve moderately complex problems and/or conduct moderately
complex analyses in partnership with provider network contracting
and program management colleagues
- Work with minimal guidance; seek guidance on the more complex
tasks
- Provide explanations and information to others on difficult
issues
- Coach, provide feedback and guide others, including provider
network contracting colleagues on network adequacy reporting
- Lead regularly scheduled meetings with the internal
stakeholders to address network adequacy gaps and collaborate on
solutions 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:
- Undergraduate degree OR -2+ years of experience with provider
network management Preferred Qualifications:
- Experience in performing network adequacy analysis and
evaluating for gap filling
- Knowledge and understanding of military protocol
- Database experience
- Experience using standard analytics to determine priorities to
determine network contracting priorities, and determining what
solutions are best for structure
- Intermediate proficiency with MS Office, ability to interpret
and make decisions on outputs Soft Skills:
- Proven analytical, problem-solving, communication, relationship
building and documentation skills
- Ability to work independently in a fast-paced environment,
adapt to changing requirements, self motivate, influence and
negotiate through verbal and written interpersonal means
- Proven strong project-tracking and follow-up skills 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 with Optum.
Here's the idea. We built an entire organization around one giant
objective; make health care 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. Colorado, Connecticut or Nevada
Residents Only: -The salary range for Colorado residents is $54,400
to $97,000. The salary range for Connecticut / Nevada residents is
$60,000 to $106,700. 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. Keywords: #RPO, Optum, UnitedHealth,
UnitedHealth Group, JOB TITLE, LOCATION, #COLOR
Keywords: UnitedHealth Group, San Jose , Senior Network Programs Specialist, Other , San Jose, California
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