Manager, Provider Network Contracting - Remote

UnitedHealth Group•Dallas, TX

3d•$91,700 - $163,700•Remote

About The Position

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together The opportunity. As a Manager within our Network Contracting team, you will lead physician and facility contracting strategies that strengthen network access, affordability, stability and provider performance. You will oversee complex negotiations across hospital systems, ambulatory facilities, independent and employed physician groups, and other high-impact provider organizations. The role combines market strategy, contract development, financial analysis, relationship management and people leadership, with accountability for delivering contracting outcomes that support business, network and medical cost objectives. How you will make an impact. You will serve as a senior contracting partner to internal leaders and external provider executives, translating market needs and financial insights into actionable negotiation strategies. You will guide your team through the full contracting lifecycle, from opportunity assessment and negotiation planning through execution, implementation and ongoing contract performance management.

Requirements

5+ years of experience in network management or provider contracting with direct responsibility for complex physician and facility providers and accountability for business results
3+ years of supervisory or people leadership experience
2+ years of direct provider contracting experience, including facility contracting and physician or medical group negotiations
2+ years of experience contributing to product pricing, using financial modeling to support rate decisions, and managing medical cost and administrative budgets
Demonstrated experience developing negotiation strategies, evaluating contract economics and leading agreements from initial assessment through execution and implementation
Experience interpreting financial, utilization, network and market data and translating findings into clear contracting recommendations
Advanced knowledge of provider reimbursement methodologies, including Medicare RBRVS, DRGs, ambulatory surgery center groupers, fee schedules, case rates, per diems and related payment structures
Demonstrated ability to manage competing priorities, lead through ambiguity and influence internal and external stakeholders without direct authority
Driver’s license and access to reliable transportation
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Nice To Haves

Experience negotiating with hospital systems, large physician organizations, ambulatory facilities or other complex provider entities
Experience with value-based, performance-based or total cost-of-care contracting arrangements
Working knowledge of contract implementation, provider data, claims operations, network adequacy and provider directory dependencies
Proven solid executive communication, presentation, relationship management and conflict-resolution skills

Responsibilities

Lead the development and execution of physician and facility contracting strategies aligned with market affordability, network access, product and growth objectives
Own and direct complex negotiations with hospitals, health systems, ambulatory surgery centers, ancillary facilities, independent physician associations, large medical groups and other physician organizations
Evaluate, structure and negotiate contract terms using approved company templates, reimbursement standards and process controls, including fee schedules, case rates, per diems, DRG-based methodologies, RBRVS-based physician reimbursement, ASC groupers and other value-oriented arrangements
Develop negotiation positions and contract recommendations using financial modeling, unit cost analysis, utilization trends, competitive intelligence, provider performance information and total cost-of-care considerations
Assess the financial and network impact of proposed rate changes, contract provisions, renewals, amendments, terminations and new provider arrangements; clearly communicate risks, tradeoffs and recommendations to leadership
Manage physician and facility unit cost budgets, affordability targets, forecasts, savings commitments, performance reporting and associated financial models
Guide the development and maintenance of geographically competitive, broad-access and stable physician and facility networks that meet specialty, service-area, product and regulatory requirements
Identify network gaps, concentration risks and contracting opportunities across physician specialties, hospitals and facility types; establish action plans to improve network adequacy and market competitiveness
Build and maintain effective executive-level relationships with hospital and health-system leaders, facility administrators, physician group executives and other key provider stakeholders
Lead contract issue resolution and escalation activities involving reimbursement, contract interpretation, implementation, operational performance, network disruption and provider relationship concerns
Partner cross-functionally with network analytics, pricing, finance, legal, medical economics, operations, claims, product, sales and market leadership to ensure contracts are financially sound, operationally executable and aligned with business priorities
Ensure accurate and timely transition of executed agreements to implementation teams, including clear documentation of negotiated terms, effective dates, reimbursement exhibits and operational requirements
Monitor post-implementation contract performance and provider results; initiate corrective action or renegotiation when outcomes do not align with contractual, financial or network expectations
Set team direction, establish priorities, coach contracting professionals, resolve complex problems and promote consistent use of negotiation discipline, documentation and governance processes
Influence forecasting, planning and market strategy by providing leadership with clear insights on provider dynamics, contracting risk, network performance and emerging physician and facility trends
Create a high-accountability team culture centered on preparation, disciplined negotiation, timely execution, sound judgment and measurable business results
Provide hands-on coaching for complex physician and facility negotiations, including strategy development, financial positioning, executive presentations and escalation planning
Represent the organization credibly with provider executives and internal senior leaders, balancing relationship stewardship with affordability, access and contract compliance objectives
Develop team capability in reimbursement methodologies, financial analysis, market intelligence, contracting systems and end-to-end contract management