Network Contract Manager - Remote

UnitedHealth Group•Torrance, CA

1d•$72,800 - $130,000•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. The Network Contract Manager will manage performance targets, reporting, and financial models while building strong, geographically competitive networks that meet organizational goals. You’ll negotiate provider contracts, ensure balanced network composition, and drive growth through strategic forecasting and gap analysis. This position also involves hosting Joint Operating Committee meetings, educating accounts on compliance and best practices, and collaborating across departments to deliver creative solutions. If you’re self-motivated, relationship-driven, and ready to make an impact, this is the opportunity for you! You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Requirements

4+ years of experience in a network management-related role, such as contracting or provider services
3+ years of experience in fee schedule development using actuarial models
3+ years of experience using financial models and analysis to negotiate rates with providers
3+ years of experience in performing network adequacy analysis
In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
Intermediate level of knowledge of claims processing systems and guidelines
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Responsibilities

Manage performance target setting, performance reporting and associated financial models relative to provider network contracting
Guide development of geographically competitive, broad access, stable networks that achieve objectives
Evaluate, understand, and negotiate provider contracts in compliance with company templates, reimbursement structure standards and other key process controls
Ensure that network composition includes an appropriate distribution of provider specialty types
Influence and/or provide input to forecasting and planning activities for network growth
Establish and maintain strong business relationships with assigned providers and internal partners
Research provider footprint and evaluate for gap filling
Host Joint Operating Committee (JOC) meetings with accounts and present to senior leaders
Educate accounts on a wide range of topics to enhance their knowledge and compliance with policies, procedures, and best practices, in collaboration with others
Understand and engage with other departments to support all aspects of provider relations
Develop and maintain beneficial relationships with key departments to support account management
Think outside the box to develop creative solutions for account challenges
Work independently with strong self-guidance and motivation
Monitor and assist accounts' with OSHA compliance to ensure safety standards are met