UnitedHealth Group is among the most ambitious Fortune 25 companies you'll ever meet. Through our family of businesses, we're working to make the health care system perform better for more people, in more ways than ever.
Simply put, we think the entire system can be greater than it's ever been. And that drives us to work harder, aim higher, and expect more from one another.
Here, you'll be empowered to make an immediate impact for millions of others. And you'll achieve more than you ever expected. How does that fit with your plans?
Professional Dental Network Relations Manager - Santa Ana-314328
UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.
Description OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
If you want more meaning in your career - as a clinician or a business professional - think of OptumHealth as your calling.
By providing 60 million Americans with information, tools and solutions, we are helping to guide them through the health care system, financing their health care needs, and enabling them to achieve their personal health and well-being goals.
Functional Description:
- Manage the day to day processes resulting in the development & maintenance of managed Dental provider networks including DHMO, Direct Compensation, and Government Programs. Networks would be based regionally.
- This role is responsible for a defined team of recruiter/relations specialists. Manage the end-to-end provider on-boarding and servicing experience, including contractual negotiations and renewals that are yield a geographically competitive, broad access, and stable network. Ensures new and existing provider contract reimbursement levels meet defined cost of care standards, thereby; offering an affordable, predictable, and an appropriate distribution of provider types that meets expectation of management, sales and account management teams.
- Assist in the development strategies for resolution of identified service gaps for practitioners, members, and clients.
- Establishes and maintain relationships with both internal and external customers.
General Profile:
- Provides leadership to and is accountable for the performance direct reports
- Develops and executes strategies on the local, regional, and national level that spans both internal and external customer expectations
- Works cross-functionally with internal and external customers and recruiters.
- Identify and assist in resolution and resolve business problems impacting internal and external customer satisfaction
- Subject Matter Expert in the area of provider network development (growth, retention, and pricing)
- Consult regarding product, service or process gaps, assisting with gap analysis, competitive analysis, and strategy development
- Drives programs that impact recruiter effectiveness within markets
- Influences or provides input to forecasting and planning activities
- Executes strategies or functional and operational objectives positively impacting business objectives
- Product, service or process decisions are most likely to impact the entire enterprise, industry, and/or marketplace
At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined. Qualifications
- 5-7 yrs provider network development experience
- 0-3 yrs management experience in a healthcare provider network development organization and ability to build and focus a team of direct reports
- General Healthcare Insurance industry experience, particularly in managed care compensation models such as DHMO and Direct Compensation
- Knowledge of Government Programs contracting and state level requirements preferred
- Knowledge of CA regulations, specifically Department of Managed HealthCare and Knox Keene licensure
- Solid knowledge of end to end provider contracting process
- Knowledge of provider reimbursement methods
- Excellent verbal and written communication skills
- Assists and or develops network development strategies
- Ability to drive strategy execution to meet strategy objective
- Excellent documentation and computer skills
- Ability to work cross-functionally to achieve network development objectives
- Knowledge of key direct competitors and in-direct competitors when appropriate
- Report creation experience, the ability to interpret, and take action on trend reporting is essential
- Familiarity with GeoAccess reporting tools preferred, but not required
- Knowledge of provider office operations and dental practice management procedures philosophies
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. |
