Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)

We are seeking a Senior Provider Relations Manager, a subject matter expert in network operations. This position is responsible for analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning within the market. This position will assist the Director of Provider Relations in achieving short and long term operational and strategic goals by developing the provider network, yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners. He or she will evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining strong business relationships with providers, and ensuring the network composition includes an appropriate distribution of provider specialties.

If you are located in the state of Texas, you will have the flexibility to telecommute* as you take on some tough challenges.

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• Assess and interpret customer needs and requirements
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• Identify solutions to non-standard requests and problems
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• Solve moderately complex problems and/or conduct moderately complex analyses
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• Work with minimal guidance; seek guidance on only the most complex tasks
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• Translate concepts into practice
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• Provide explanations and information to others on difficult issues
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• Coach, provide feedback, and guide others
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• Act as a resource for others with less experience
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Youll 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.

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• Undergraduate degree or equivalent related work experience
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• 2+ years of experience in a network management-related role, such as contracting or provider services
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• 2+ years of experience utilizing financial models and analysis in negotiating rates with providers
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• 2+ years of experience in performing network adequacy analysis
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• Knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)
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• Access to reliable transportation and ability to travel 50% regionally
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• If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained.
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• Knowledge of claims processing systems and guidelines
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Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 380,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCares support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords:healthcare, health care, contracting, provider, physician, network management, negotiation, analysis, travel, field, Medicare, WellMed, Texas, Telecommute