Network Contract Manager - Remote PA

UnitedHealth Group•Philadelphia, PA

2d•$72,800 - $130,000•Remote

About The Position

Network Contract Managers develop provider networks that are geographically competitive, offer broad access, remain stable, and meet unit-cost performance and trend-management objectives. The role supports affordable and predictable products for customers and business partners by evaluating and negotiating provider contracts in accordance with company contract templates, reimbursement standards, and other process controls. It also involves maintaining provider relationships and ensuring an appropriate distribution of provider specialties in the network. The position manages network unit-cost budgets, targets, performance reporting, and related financial models; supports network adequacy and recruitment; and works with internal teams on regulatory requirements affecting provider contracts. The manager maintains existing contracts, identifies savings opportunities, coordinates complex negotiations, and works with facility and hospital providers and internal partners to address contract-administration issues. The role is remote for candidates located in Pennsylvania and requires success in a demanding, fast-paced environment with complex negotiations and careful attention to accuracy.

Requirements

At least 2 years of experience in a network management-related role, such as contracting or provider services.
Experience using financial models and/or financial analysis to negotiate provider rates or meet other business needs.
Experience performing network adequacy analysis.
Knowledge of Medicaid and/or Medicare.
Intermediate knowledge of claims processing systems and guidelines.
Excellent verbal and written communication skills, including the ability to convey complex or technical information clearly and understand and interpret complex information from others.
Valid driver’s license and access to reliable transportation.

Nice To Haves

Experience in Payment Appendix and fee schedule development.
Experience with New York Medicaid services and reimbursement methodologies.
Behavioral Health provider experience.
Facility or hospital contracting experience.
Knowledge of the Pennsylvania/Northeast market.
Sound interpersonal skills, including establishing rapport and working well with others.
Sound customer service skills.

Responsibilities

Manage unit-cost budgets, target setting, performance reporting, and associated financial models.
Guide development of geographically competitive, broad-access, stable networks that meet unit-cost performance and trend-management objectives.
Evaluate and negotiate contracts, reimbursement methodologies, and rates in compliance with company templates, reimbursement standards, and process controls.
Manage unit-cost targets, performance reporting, and associated financial models.
Ensure appropriate provider-specialty distribution and network adequacy through recruitment and contracting.
Work with internal contacts to implement regulatory requirements affecting provider contracts, including state-specific rate changes, coding, new services, and requirements.
Maintain existing network contracts and manage contracting events during the agreement term while generating savings opportunities for affordability initiatives.
Coordinate high-profile negotiations and build and nurture trusted relationships with providers and internal stakeholders.
Engage facility and hospital providers and internal resources to resolve contract-administration issues.
Provide explanations and information to others on difficult issues.