Business Development Contractor - (US-TX-Houston - 77299)

Minimum Education: None
Job Type: Full Time
Jobcode: N/A
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Responsibilities: Coordinate and assist in all contracting activities within a target market for Medicare Advantage products Required Skills Universal American provides network-based health and well-being benefits and services for Medicare Beneficiaries nationwide. We use our strength, diversity and innovation to improve the lives of the more than 18 million people who receive our unique products and services. And our endless pursuit for excellence in everything we do extends to your career as well. Join us today for an inspired and purposeful mix of professional growth opportunities and personal rewards. This role involves the development of the provider network (physicians, hospitals, PHO's, IPA's, and Ancillary Providers) 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. Also, essential to this position is that the individual evaluates, negotiates and fully comprehends contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Establishes and maintains strong business relationships with Hospitals and Physicians as well as these other critical Works with§ Generally work is self-directed and not prescribed §components.   Assesses and interprets customer needs§less structured, more complex issues  § Identifies solutions to non-standard requests and problems §and requirements  §Solves moderately complex problems and/or conducts moderately complex analyses  §Works with minimal guidance; seeks guidance on only the most complex tasks. Requirements: Willing to travel up to 75% of time (if required Required Experience Two to six years in a network development/contract management role, such as§  Bachelor's degree in business, health§contracting and/or network operations  care management, or related field. (Significant additional experience may be considered in lieu of a Bachelors degree, at the discretion of the hiring  Demonstrated effective negotiation skills and§manager)   High degree of proficiency in utilizing and§implementation/influencing skills   Strong knowledge§interpreting financial models and network adequacy analyses  of RBRVS, DRG HHC and APC reimbursement methodologies and clear understanding of  Experience applying pricing,§Medicare based claims processing guidelines   Problem§financial analyses, contracting standards and negotiation strategies  solving skills, including the ability to systematically analyze complex problems, draw relevant conclusions, and successfully devise/implement  Excellent verbal and written communication skills;§appropriate solutions  ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to  Ability to multi-task,§understand and interpret CMS standards and guidelines..

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