Network Program Manager

Job title:

Network Program Manager

Company:

UnitedHealth Group

Job description

Network Program Manager – Letterkenny/Dublin, HybridOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.About the role:As a Fortune 5 business, we’re one of the world’s leading healthcare companies. There are no limits here on the resources you’ll have or the challenges you’ll encounter.We have been supporting global healthcare systems from Ireland and the UK for more than 20 years, building a dynamic and diverse team of more than 2,100 talented individuals. With a continued record of growth and stability, we’re on the constant lookout for fresh talent to join our expanding team’s healthcare system work better for everyone.As a Network Program Manager, this role will be part of the OON (Out of Network) strategies team, you will manage and develop programs that impact UnitedHealthcare’s (UHC’s) relationships with both its administrative services clients and contracted (“network”) / non-contracted (“out of network”) care providers. You will manage ASO (Administrative Services Only) programs, helping to build and develop solutions that meet the needs of our ASO and self-funded clients across UnitedHealthcare. These “ASO” clients employ UHC’s administrative capabilities and medical cost management solutions (including the management of care provider networks), while funding the cost of health benefits for their membership themselves. You will take the lead in building effective management strategies pertaining to UHC’s interactions with these network and out-of-network providers on the behalf of our clients to meet client market needs. You will work closely with Client Reporting and Analytics teams to build new informatics packages that demonstrate the impact of solutions and opportunities for more effective management of client health benefit plans. You will partner with internal and external stakeholders to help develop and implement ASO medical cost savings initiatives both nationally and on a client specific level.Primary Roles & Responsibilities of a Network Program Manager:

• Partner with US-based Out of Network Payment Strategy Team
• Follow team direction, resolve problems, and provide guidance to our business partners, Promotes Employee Engagement & Talent Development
• Participates in the development of business strategy, adapts departmental plans and priorities to address business and operational challenges
• Influences or provides input to forecasting and planning activities when required
• Build insightful competitive intelligence to inform ASO and fully insured (clients for whom UHC also finances healthcare benefits in addition to providing administration) strategies (i.e., other payers, vendor programs, etc)
• Analyze claim outcome performance along key indicators (e.g., compliance with regulatory audits, financial performance) to determine which programs to implement and/or modify
• Validate inventory data for programs and work with business partners and clients as needed to resolve issues
• Develop metrics and create performance reports for business partners and clients
• Provide input and feedback to senior leadership to suggest/recommend improvements to programs
• Create and/or implement communication/training materials (e.g., talking points; FAQs; step action chart; metric evaluation tools) to educate business partners and clients on new programs and/or processes
• Seek feedback from relevant internal and/or external stakeholders regarding potential program/network improvement opportunities and needs
• Collaborate with relevant internal and/or external stakeholders to resolve issues and obstacles with program performance
• Communicate with applicable stakeholders to provide performance updates regarding programs or inventory (e.g., objectives; goals; timelines; schedules; issues; performance against standard contract agreements)
• Follow-up with stakeholders to ensure issues have been resolved and addressed effectively and timely
• Manage relationships with business partners and clients to ensure program SLAs are met

Required Qualifications of a Network Program Manager:

• Undergraduate degree in applicable area of expertise or equivalent experience, prior experience in a claim’s role
• Excellent communication and interpersonal skills, including ability to communicate effectively with various levels of leadership
• Experience working in a technology-enabled service industry, ideally with claims systems, cash management and application systems, pricing systems, or another transactional platform
• Experience using UNET platform is required
• Experience in data analysis and the ability to convey complex or technical information in a manner that others can understand
• Proven ability to understand complex business processes and business-to-business ecosystems, with Project management experience
• Decisive decision making, with Proven experience delivering tangible value through programs directly led or overseen
• Strong MS Office, Microsoft Project, and PowerPoint skills

Preferred Qualifications of a Network Program Manager:

• Strong analytic skills to aid assessment of potential program opportunities, evaluation of program success/savings and to evaluate business risk impact
• Proven ability to work independently in the application of company goals and philosophies
• Demonstration of critical thinking skills and the ability to translate into results in a complex, matrixed and often ambiguous environment
• Demonstrated ability to multitask, organize and prioritize work and continue to monitor and make changes to work as the project needs dictate
• Proven ability to work independently in the application of company goals and philosophies
• Demonstrated ability to build and maintain relationships; proven collaboration and influencing skills with both internal and external organizations

Please note you must currently be eligible to work and remain indefinitely without any restrictions in the country to which you are making an application. Proof will be required to support your application.For more information on our Internal Job Posting Policy, click .All telecommuters will be required to adhere to the UnitedHealth Group’s Telecommuter Policy.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 marginalised 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: Optum is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to gender, civil status, family status, sexual orientation, disability, religion, age, race, and membership of the Traveller community, or any other characteristic protected by law. Optum is a drug-free workplace. © 2024 Optum Services (Ireland) Limited. All rights reserved.#RPO

Expected salary

Location

Letterkenny, Co Donegal

Job date

Sat, 25 Jan 2025 23:00:42 GMT

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