83 applicants

Company

Optum · 14 hours ago

Network Program Manager (Remote in northern AZ)

Phoenix, AZ

Full-time

Remote

Mid, Senior Level

5+ years exp

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EducationHealth Care

H1B Sponsor Likely

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Responsibilities

Wide range of activities pertaining to strategic planning and analysis, medical data analysis (RAF), disease management, chronic care models, and STARs/HEDIS quality interactions

Educates PCPs and their staff members on health plan products and processes, develops project plans which identify key issues, problems, approaches, performance metrics and resources required and provides staff leadership to multi-disciplinary teams. Serves as a liaison between provider and OptumCare

Maintain and obtain contracts within assigned territory

Assess and interpret customer needs and requirements

Identify solutions to non-standard requests and problems

Solve moderately complex problems and/or conduct moderately complex analyses

Work with minimal guidance; seek guidance on only the most complex tasks

Translate concepts into practice

Provide explanations and information to others on difficult issues

Coach and provide feedback to assigned PCP practices on OptumCare processes

Act as a resource for others with new staff or others with less experience

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Network data managementClaims systemsContract reimbursement methodologiesMS OfficeProvider data analysisMedicare AdvantageHEDISProject planning

Required

5+ years of experience with network data management in a managed care environment

2+ years of experience working with claims systems

Intermediate proficiency in MS Office (Excel, Access and PowerPoint)

Expertise in physician/facility/ancillary contract reimbursement methodologies

Proven ability to work closely with providers to meet OptumCare policies and procedures

Proven ability to convey complex information to others and make it more easily understood

Proven ability to prioritize multiple tasks in an environment of rapid change

Live within the northern Arizona area

Preferred

3+ years of experience with claims processing systems and provider databases

3+ years of experience in provider data analysis and communicating metrics

3+ years of Medicare Advantage experience, risk adjustment, HEDIS, and working closely with providers in these areas

Proven excellent communication skills, including ability to communicate effectively with various levels of leadership

Company

Optum

Glassdoor

3.6

Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.

Founded in 2011

Eden Prairie, Minnesota, USA

10001+ employees

https://www.optum.com/

H1B Sponsorship

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2023 (470)

2022 (822)

2021 (646)

2020 (458)