Network Contract Manager - Remote (Midwest preferred)

UnitedHealth Group•Minnetonka, MN

2d•$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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. It's a big step forward when you realize that you've earned the trust to lead a team. Now, let's determine just how big that step can be. Take on this managerial 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. As a manager within our network contracting team, 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. If you are located in Midwest, you will have the flexibility to work remotely as you take on some tough challenges. This is an intense, fast-paced environment that can be demanding. In addition there are some data challenges and unique problems that need to be solved related to gaps in the process. Develops 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. 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, Pharmacy, or Ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties. Employees in jobs labeled with ‘SCA’ must support a government Service Contract Act (SCA) agreement. Generally work is self-directed and not prescribed. Works with less structured, more complex issues. Serves as a resource to others. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Requirements

4+ years of experience in a network management-related role, such as contracting, CME or roster management
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 unit cost budgets, target setting, performance reporting and associated financial models
Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management
Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls
Ensure that network composition includes an appropriate distribution of provider specialties
Provide explanations and information to others on difficult issues
Coach, provide feedback and guide others