UnitedHealth Group Healthcare Director, Provider Network Strategy - Anchorage, AK in Anchorage, Alaska
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As a key member of the health plan leadership team, the Director of Network Strategy will work closely with the provider community in Anchorage and Mat-Su to build the program of the Medicaid Coordinated Care project with the state of Alaska. The role is responsible for the successful program design, compliance with network requirements, network assessment and selection, and program / product implementation.
This new market opportunity includes enterprise-wide Clinically Integrated Network teams that focus on specific clinical area Lines of Service (e.g., Cardiology, Women's Health, Oncology, etc.) to improve the quality and affordability through improvements in appropriateness and effectiveness.
The successful candidate will work closely with Native Alaskan providers and health organizations to establish strong working relationships to ensure their members receive quality care. The Director of Network Strategy will perform network analysis and strategy development and implementation; obtain data, verify validity of data, and analyze data as required, and analyze network availability and access.
Other responsibilities may also include making recommendations regarding use, expansion, selection of networks for various products based on that analysis.
Primary Responsibilities: Build strong relationships with the Provider Communities in Anchorage and Mat-Su to be able to understand and develop strategies to meet those needs Brings a strong focus to the Native Alaskan Providers and Health organizations.
Works closely with those organizations to develop and execute plans to positively impact their member’s health. Is responsible for the successful program design, compliance with network requirements, network assessment and selection, and program / product implementation Working closely with the Accountable Care organization, ensures that we are engaging the provider community in ways that allows them to interact in the most effective way for their patients. This could include delegating case management or other functions to them, developing Value Based Contracts or other incentives. Direct others to resolve business problems that affect multiple functions or disciplines Performs Network Analysis to ensure that we have the right network design for the project This role will also be responsible for owning the network components of any audit, compliance, complaints and grievances Required Qualifications: Undergraduate degree or equivalent experience 8+ years of experience working with a managed care organization, health insurer, or consultant in a network management / contract management role, such as contracting, provider services, etc.
7+ years of experience in data analysis 5+ years of experience managing staff Strong working knowledge of the Anchorage/Mat-Su Provider communities Previous successful experience engaging with and supporting the Native Alaskan communities.
3+ years of project management or project lead experience Expert level of proficiency with all facility / ancillary contract reimbursement methodologies 5+ years of experience with claims systems Strong knowledge of business processes that impact facility / ancillary contact loading and auditing 3+ years of experience with contract submission, validation and maintenance Advanced proficiency in MS Office (Excel, Access and PowerPoint) Preferred Qualifications: Ability to convey complex or technical information in a manner that others can understand Excellent communication skills, including ability to communicate effectively with various levels of leadership Careers at UnitedHealthcare Community & State.
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It also attracts the best.
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We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy.
Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors.
Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most.
This is the place 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: Network, Director, Medicaid, Contracting, Provider, Director, of Network Strategy Anchorage, AK, Alaska dea96e6f-ec94-4e8b-9080-ba71a703853d
Healthcare Director, Provider Network Strategy - Anchorage, AK Alaska-Anchorage 756005