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Senior Network Program Specialist

Company: UnitedHealth Group
Location: Miami
Posted on: November 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 higher) OR -2+ years of experience with provider network management
    • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state, and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

      Preferred Qualifications:

      • Experience in performing network adequacy analysis and evaluating for gap filling
      • Intermediate proficiency with MS Office, ability to interpret and make decisions on outputs
      • 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

        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, Nevada or New York City Residents Only: -The salary range for Colorado residents is $54,400 to $97,000. The salary range for -Connecticut / Nevada / New York City -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: UnitedHealth Group, Miami , Senior Network Program Specialist, Other , Miami, Florida

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