Associate Network Contractor

UnitedHealth Group•North Charleston, SC

7d•$24 - $43•Remote

About The Position

Optum 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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Here you are in the earlier stages of what could be a deeply rewarding career. You have the potential, the energy and the aspiration to take on meaningful challenges and make a difference. Now, let's talk about what you can do with our leading, global health care organization. UnitedHealth Group is playing a lead role in the formation of new, effective provider networks. As member of our network contracting team, you'll help develop and support Provider Networks and guide unit cost management activities through financial and network pricing modeling, analysis and reporting. As you do, you'll find the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 6 leader. You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.

Requirements

High School diploma/GED
1+ years of experience in a network management-related role, such as contracting or provider services
1+ years of experience in fee schedule development using actuarial models
1+ years of experience using financial models and analysis to negotiate rates with providers
1+ years of experience in performing network adequacy analysis
At least an intermediate level of knowledge of claims processing systems and guidelines
Advanced Proficient skillset in Microsoft Excel; ability to create pivot tables, work with large data, create formulas, de-dupe, etc.

Nice To Haves

Undergraduate degree
In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)

Responsibilities

Supports the development of the provider network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.) 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
Manage unit cost budgets, target setting, performance reporting and associated financial models
Predict emerging customer needs and develop innovative solutions to meet them
Help develop geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management
Evaluate and support contract negotiations in compliance with company templates, reimbursement structure standards and other key process controls
Ensure that network composition includes an appropriate distribution of provider specialties
Uses existing procedures and facts to solve routine problems or conduct routine analyses
Get ready for a high impact role. You'll be tasked with working in conjunction with our national clinics and hospitals to manage, collect and analyze provider data, updating and loading provider data and resolving any escalated issues with the clients.
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.