Mike Himes
- Role
- Senior Network Contract Manager at UnitedHealth Group
- Location
- Austin, TX, US
- LinkedIn followers
- 500 followers
Experience
Senior Network Contract Manager
Aug 2016 — Present · Austin, TX, US
Returned to Network Management in an expanded senior role; key responsibilities included handling key provider accounts, mentoring and coaching junior contractors, and leading process improvement initiatives • Cultivated provider physician network for UnitedHealthcare Network Management • Yielded a geographically competitive, broad access, stable network that achieved objectives for unit cost performance and trend management • Evaluated and negotiated contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls • Established strong business relationships with hospital, physician, pharmacy, and ancillary providers • Ensured the network composition included an appropriate distribution of provider specialties • Provided analysis, explanations and interpretations to peers and providers within area of expertise • Obtained favorable fee arrangements from all providers recruited in a defined geographic territory • Communicated with network management and support staff daily to report and request status inquiries • Administered provider contracting and network maintenance initiatives for the Austin, TX market (including but not limited to the counties in and around the Austin, San Marcos and Waco metropolitan areas)
Education
Austin Community College
Project Management / Information Technology Project Management
2015 — 2015
Connecticut School of Broadcasting
Broadcasting Diploma, Radio and Television Broadcasting
2000 — 2000
State University of New York - System
AA, Liberal Arts and Science-Humanities and Social Science
1997 — 2000
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