Network Contract Manager - Remote

UnitedHealth Group•Minneapolis, MN

9h•$72,800 - $130,000•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 equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. Take on this VACCN (Veterans Affairs Community Care Network) Network Contract Manager role with UnitedHealth Group and you'll be part of a team that's reshaping how provider networks evolve and how health care works better for millions. You'll guide the development and support of Provider Networks as well as unit cost management activities through financial and network pricing modeling, analysis, and reporting. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 5 leader. Jobs related to provider network contract negotiation and pricing support the development of geographically competitive, broad access, stable provider network that is both affordable and predictable. Develops the provider network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.) yielding a geographically competitive, broad access, stable network that achieves objectives for cost performance and trend management and produces an affordable and predictable product for customers and business partners. Evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Establishes and maintains strong business relationships with Hospital, Physician, or Ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties. If you are able to work Eastern (EST) Time zone and Central (CST) Time zone work hours, you will have the flexibility to work remotely as you take on some tough challenges.

Requirements

3+ years of experience in a network management-related role, such as provider contracting or provider relations
3+ years of experience in working directly with providers on contract language and fee schedule negotiations
3+ years of experience using financial models and analysis to negotiate rates with providers
3+ years of experience in reviewing and acting upon network adequacy analysis to ensure compliance with customer requirements
In-depth knowledge of Medicare and other industry-standard payment methodologies
Intermediate level of knowledge of claims processes, including but not limited to claims submissions and adjudication systems and guidelines
Proven solid communication skills
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Responsibilities

Demonstrate understanding of VACCN program; and if applicable, products for different lines of business
Evaluate current VACCN contract performance to identify potential remediation opportunities and/or cost savings
Demonstrate understanding of and utilize applicable tools and reports to evaluate performance of current contracts
Demonstrate understanding of contract language to assess financial and operational impact and legal implications of requested contract changes
Demonstrate understanding of provider network landscape within the assigned territory
Balance financial and operational impact of contracts to providers, members, UHN, VACCN and different customer groups, where applicable, when developing and/or negotiating contract terms
Weigh financial and operational information to evaluate continued provider participation
Demonstrate understanding of contract language and terms of agreement to ensure that financial/operational impact and legal implications are aligned with business objectives
Utilize appropriate contract management systems to author and execute contracts and to access supplemental contractual documents
Demonstrate understanding of submission tools to ensure accurate and timely contract configuration for customer groups
Communicate proposed contractual terms with provider and negotiate mutually acceptable agreement
Represent department in external meetings and take appropriate action
Monitor and/or oversee provider performance to identify opportunities to improve
Communicate contractual and/or operational performance to providers to ensure compliance with contractual terms and protocols
Demonstrate understanding of provider termination process