Contracted Networks Manager
7 days left
- Employment Status
- Full Time
Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs. UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.
ABOUT UCAREAt UCare, we deliver high-quality health coverage and services to help members of all ages maintain and improve their health. It's a big job that takes innovative ideas, strategic partnerships, and a commitment to doing the right thing. Above all, it takes a compassionate team that is dedicated to making a real difference in the lives of our members and our communities.WORKING AT UCAREWorking at UCare is more than just a career; it's a mission. A mission that defines us as professionals, unites us as an organization, and shapes how we interact with our members and each other. Our values of integrity, community, quality, flexibility, and respect permeate every aspect of our organization - from who we are and how we act, to what we do and how we do it. We owe our continued success to our employees who proudly embody our mission and values in everything they do. CONTRACTED NETWORKS MANAGERThis position is responsible for managing UCare's ancillary contracting team in order to develop, implement, oversee and retain professional, vendor and ancillary provider networks. Team is responsible for contracting and auditing, in addition to managing strategic projects and special initiatives. Team is also accountable for building and maintaining strong provider relationships. ·Coach, mentor, and manage a high-performing team of professionals to create and maintain ancillary networks, build and strengthen relationships with key providers, and support UCare's strategic provider-related goals.·Participate in development of provider network and contracting strategy. Deliver provider market intelligence and insights to key internal provider forums to inform direction and decisions. Develop and manage key initiatives related to specific contracted networks.·Manage annual negotiation plan in collaboration with teams and other internal stakeholders. Report status quarterly to department leadership and key committees.
·Manage and maintain network oversight plans by provider/network type. Ensure contractual, regulatory and NCQA compliance for network providers.
·Manage monthly, quarterly, and annual departmental metrics and attainment of individual annual goals and department goals. Develop and maintain new methods of documenting activities.
·Coordinate the contracting process for professional, vendor and ancillary services including completion of contracts and other documentation to ensure contractual terms are implemented in the system timely and accurately.·Develop and maintain provider networks to ensure adequate coverage for all products. Monitor new and existing provider networks for expansion opportunities and develop action plans for addressing deficiencies. Initiate and orchestrate provider recruitment, contracting, oversight, reporting and related development efforts.·Participate on assigned UCare committees and work groups to represent departmental interests. Regularly engage department staff as needed to meet committee objectives and report to department leadership and staff as appropriate.·Support strategic and operational efforts as needed.·Other projects and duties as assigned.EducationBachelor's degree in health care management, finance, or related field required. Required ExperienceEight years of experience in a health plan or health care organization with managerial responsibility for provider related functions (network analysis, contracting, reimbursement, etc). Experience working with ancillary healthcare providers (DME, PCA, Transportation, Mental Health). Ability to lead cross-departmental teams. Knowledge of health plan functions including: product management, operations, marketing/sales, compliance, information systems, data analysis and clinical.Preferred ExperienceKnowledge of local provider systems. Knowledge of state and federal health care programs. THE UCARE DIFFERENCEUCare is proud to be a recognized Star Tribune Top Workplace for the 9th consecutive year. As a part of our collaborative team, you'll experience the rewards that come with helping others and seeing the positive results of your hard work. We value and respect each individual's ideas and contributions, and give you the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, a myriad of volunteer activities, and a number of other rewards. If you're looking for a welcoming environment that celebrates what you have to offer, helps you build on your strengths, and gives you the opportunity to truly make a difference, we invite you to apply. As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.