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Associate Director, Network Management - Kingsville, Corpus Christi or Victoria, TX

Company: UnitedHealth Group
Location: Victoria
Posted on: February 3, 2020

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) The Associate Director, Network Management has management responsibility for day to day market operations. The position is responsible for facilitating the creation and execution of local market strategies and action plans. The position is involved in planning, budgeting, forecasting, facility planning and reporting for each of the assigned markets. This will include overseeing network development, network management and local office management in assigned markets. This position may supervise multiple markets as directed. This position has a dotted line matrix management responsibility for all other functional staff located within assigned markets - including marketing, utilization management, disease management, transportation, DataRAPS, quality and vendors. This position works cross functionally with all other divisions in the corporation including, medical management, , finance, claims, customer and member services, IT and facilities to achieve market goals and objectives. The responsibilities of this position demand a wide range of capabilities including: strategic planning and analysis skills; strong accounting knowledge and understanding of financial statements; understanding of managed care contracts; management breadth to direct and motivate; highly developed communication skills; political savvy; and the ability to develop clear action plans and drive process, given often ambiguous issues with numerous interdependencies. Analyzes data from a variety of statistical and financial reports and develops recommendations, strategic plans and action plans to improve identified financial deficits. This position will work closely with key payor and physician groups to develop long-term strategic relationships. If you are located  near Kingsville, Corpus Christi or Victoria, TX , you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: Responsible for supervision of market personnel to include hiring, training, coaching and development to maximize staff performance and technical expertise through clearly defined objectives and leadership Participates in strategic and operational planning for the assigned market(s) and facilitates the execution of the plan within that assigned market Identifies, directs, communicates and executes continuous quality improvement activities or processes to ensure initiative outcomes are met Participates in development and implementation of systems that support network operations and network management Delegate, monitor and control work progress on keymetrics, initiatives/action plans, staff productivity and administrative expenses Overall responsibility for the selection of additions to the primary care network. This includes creation of strategic plan, training of the staff to carry out the strategic plan, negotiation of the contract as well as overall implementation of new primary care provider groups Maintains effective network support services by working effectively with the Medical Director, Market Medical Director and other departments Handles complex and/or difficult provider inquires and/or problems and facilitates resolution of provider issues. Continuously strive to ensure that favorable relationships are maintained while ensuring the interest of the organization Drives change and innovation through continually seeking and implementing value added solutions for clients Communicate and advocate providers' needs to internal stakeholders in order to drive creation of solutions that meet our mutual business goals Leads multiple individual client-focused projects and motivates cross-functional participants to improve or address systematic problems or providing value to client Influence or provide input to forecasting and planning activities Analyzes data while collaborating and/or participating in discussions with colleagues and business partners to identify potential root cause of issues. Provide cross functional leadership across the enterprise by maintaining open communication, identifying, resolving cross functional issues, attain metric targets by collaboratively creating, maintaining, implementing and evaluating business strategic plans for each area, continually improving cross functional policies/procedures/work flows and support systems and proactively facilitates staff development to achieve the goals and objectives of the market Assists with and manages business projections, forecasting and budgets, both financially and with timelines, for assigned projects. Understands payer relationships within market and ensures any operational issues are visible to the appropriate parties and ensures issue resolution. Performs all other related duties as assigned It’s time to step up to some real challenge. You’ll be part of a performance driven, fast paced organization that is serving multiple markets and you’ll be managing and mentoring a production based team to meet aggressive goals. 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 in Business Administration, Marketing, Healthcare Administration or a related field required. (8 additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor’s degree) Minimum of 5 years of managed care experience with an emphasis on network management, operations, financial analysis and employee supervision. Provider contract negotiations and provider relations experience At least 4 years of management/supervisory experience (i.e. employee selection, training, coaching and development as well as process management) At least an intermediate level of knowledge of claims processing 1+ years of experience with Medicare and Medicaid regulations Exceptional presentation, written and verbal communication skills Ability and willingness to travel, both locally and non-locally, as determined by business need Proficiency in MS Word, PowerPoint, Excel and Access Preferred Qualifications: Master’s degree in Business Administration, Marketing, Healthcare Administration or a related field Strong working knowledge of Medicare health care operations including HEDIS, HCC Coding and Medicare Advantage The health system is moving ahead. You can too as you help us build new levels of provider network performance. Join us. Learn more about how you can start doing your life's best work.(sm) 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 WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth. OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare’s support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians. *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: network, manager, supervisor, training, quality, financial analysis, data, disease management, utilization management, claims, Medicare, Medicaid

Keywords: UnitedHealth Group, Victoria , Associate Director, Network Management - Kingsville, Corpus Christi or Victoria, TX, Other , Victoria, Texas

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