Network Program Manager (Remote in AZ)

UnitedHealth Group • Phoenix, AZ

444d • Remote

About The Position

The Network Program Manager is responsible for the design and implementation of network programs aimed at improving healthcare quality and affordability. This role involves compliance with network requirements, network assessment, and selection, as well as data analysis to support strategic planning and decision-making. The position serves as a liaison between providers and the organization, ensuring effective communication and collaboration to enhance healthcare delivery.

Requirements

• 5+ years of experience with network data management in a managed care environment.
• 2+ years of experience working with claims systems.
• Intermediate proficiency in MS Office (Excel, Access, PowerPoint).
• Expertise in physician/facility/ancillary contract reimbursement methodologies.
• Proven ability to work closely with providers to meet policies and procedures.
• Ability to convey complex information clearly and understandably.
• Proven ability to prioritize multiple tasks in a rapidly changing environment.
• Must reside within the northern Arizona area.

Nice To Haves

• 3+ years of experience with claims processing systems and provider databases.
• 3+ years of experience in provider data analysis and communicating metrics.
• 3+ years of Medicare Advantage experience, risk adjustment, HEDIS, and provider collaboration.
• Excellent communication skills with various levels of leadership.

Responsibilities

• Design and implement enterprise-wide clinically integrated network programs.
• Conduct network analysis and strategy development.
• Obtain and verify data for analysis regarding network availability and access.
• Educate primary care providers (PCPs) and their staff on health plan products and processes.
• Develop project plans identifying key issues, performance metrics, and resources required.
• Maintain and obtain contracts within the assigned territory.
• Assess and interpret customer needs and requirements.
• Identify solutions to non-standard requests and problems.
• Solve moderately complex problems and conduct analyses as needed.
• Provide explanations and information on difficult issues to others.
• Coach and provide feedback to assigned PCP practices on processes.

Benefits

• Health insurance coverage
• Dental insurance coverage
• Vision insurance coverage
• 401k retirement savings plan
• Paid time off
• Flexible scheduling options
• Professional development opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: No Education Listed