Behavioral Health Network Manager - Golden, CO
Company: UnitedHealth Group
Location: San Diego
Posted on: June 25, 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) The BH Network Manager is responsible for developing,
maintaining, and servicing a high quality, marketable and satisfied
behavioral health provider network within an assigned geographic
area. Key responsibilities include recruitment and contracting,
education, and servicing of assigned providers. The BH Network
Manager helps assigned providers operate successfully within our
behavioral and medical healthcare delivery model by providing
strategic planning and tools to meet organizational goals. This
position is expected to build and sustain strong working
relationships with cross-functional departments, facilities and
assigned providers. The BH Network Manager is accountable for
overall performance and profitability for their assigned behavioral
health groups, as well as ownership and oversight to provide
redirection as appropriate. Primary Responsibilities:
- Ensure providers have in-depth understanding of Optum Mountain
West Region care delivery models including clinical and
business
- Conduct visits with external health care providers to promote
risk adjustment score accuracy (e.g., early detection; accurate
documentation and coding) and compliance with applicable regulatory
guidelines (e.g., CMS; HEDIS/STARS Quality Measures)
- Conduct detailed analysis of provider performance to ensure
performance goals are achieved
- Maintain open communication with providers to include issue
resolution on health plan issues related to credentialing, claims,
eligibility, care management, utilization management, quality, and
risk adjustment programs
- Collaborate with the Contracting team to ensure provider data
is correct and provider directories are maintained
- Analyze network availability and access 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 or equivalent work experience
- 5+ years working with a managed care organization or health
insurer; or as a consultant in a network/contract management role,
such as contracting, provider services, etc.
- Access to reliable transportation and ability to travel up to
50% within assigned geographic area
- Proficiency with Microsoft Office
- Expertise negotiating physician/facility/ancillary
contracts
- Full COVID-19 vaccination is an essential requirement 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 Preferred Qualifications:
- Expertise in physician/facility/ancillary contract
reimbursement methodologies
- Established knowledge of local behavioral health provider
community 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) Colorado Residents Only: The
salary/hourly range for Colorado residents is $82,100 to $146,900.
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, San Diego , Behavioral Health Network Manager - Golden, CO, Healthcare , San Diego, California
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