Manager, Provider Relations – Remote within MD/DC

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

 

The Manager, Provider Relations is responsible for Maryland Community Plan management of provider partnerships, including facility, physician, ancillary and pharmacy networks. The Manager, Provider Relations works with the COO and Health Plan Executive Leadership team to identify and execute the strategy for internal provider operations and external provider partnerships to support achievement of state partner and enterprise goals.  The Manager, Provider Relations serves as the primary Point of Contact (POC) with the state partner, MDH for Provider service issues. 

 

If you are located in Washington, DC or Columbia, MD, you will have the flexibility to work remotely* as you take on some tough challenges.

 

Primary Responsibilities:

• Serves as an entry point for both network and non-network provider dispute resolution
• Oversees health plan provider network strategy and operations including selection, credentialing, contracting, onboarding, education, relationship management, change management and implementation of value-based agreements
• Leads Governance and Joint Operating Committees (JOCs), regular and ad hoc regulatory reporting, audit preparation and performance, and accountability for network contractual measures performance
• Leads and coordinates participation in state contract program advocacy and implementation projects with vendors, internal network and other shared service partners, providers and state partners as well as health plan team members
• Provides leadership for HP process improvement and implementation projects, including but not limited to:
  • Creative reimbursement initiatives/Value Based Programs
  • Provider Data/Directory quality audits and improvement
  • Regulatory Network and Hybrid Vendor implementations and process changes
  • Strategic growth and affordability projects
• Analyzes provider performance issues to identify trends, root causes and systemic solutions that ensure performance and stakeholder satisfaction

 

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:

• 5+ years of experience in health care network and health plan operations
• Provider network and vendor management experience, including contracting/negotiation, relationship management, network oversight, data quality oversight
• Demonstrated project management skills, including ability to manage implementation, problem solving or process improvement project plans
• Demonstrated success in leading cross functional teams to achieve business objectives
• Proven excellent relationship management skills with internal and external stakeholders
• Demonstrated professional presentation and engagement skills with enterprise executives, state regulators, and providers 
• Proven analytical and systems thinking, problem solving and process improvement skills and experience
• Proven solid written and verbal communication skills
   

Preferred Qualifications: 

• 3+ years of experience in state regulatory issue resolution and advocacy
• People leadership experience
• Proven intermediate skills in Teams, Excel, and PowerPoint
   

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

 

The salary range for this role is $89,800 to $176,700 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.    

 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.   

 

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.