SanDiegoRecruiter Since 2001
the smart solution for San Diego jobs

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

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Log In or Create An Account

Get the latest California jobs by following @recnetCA on Twitter!

San Diego RSS job feeds