Network Contract Manager - Remote (Texas resident preferred)

UnitedHealth Group•Houston, TX

12d•$72,800 - $130,000•Remote

About The Position

The Network Contract Manager develops and maintains provider networks that are geographically competitive, provide broad access, and remain stable while meeting unit cost performance and trend-management objectives. The role helps produce affordable, predictable products for customers and business partners. It evaluates and negotiates provider contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. The manager also maintains strong business relationships with providers and ensures appropriate distribution of provider specialties across the network. The position is remote within the United States; Texas residents are preferred. Work is generally self-directed and not prescribed, includes less structured and more complex issues, and serves as a resource to others. The manager may explain difficult issues, coach others, provide feedback, and guide their work.

Requirements

At least 3 years of experience in a network management-related role, such as contracting or provider services.
At least 3 years of experience in fee schedule development using actuarial models.
At least 3 years of experience performing network adequacy analysis.
At least 2 years of experience using financial models and analysis to negotiate rates with providers.
In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS).
Intermediate-level knowledge of claims processing systems and guidelines.
Remote employees must adhere to UnitedHealth Group’s Telecommuter Policy.
Candidates must pass a drug test before beginning employment.

Nice To Haves

Undergraduate degree.

Responsibilities

Manage unit cost budgets, target setting, performance reporting, and associated financial models.
Guide development of geographically competitive, broad-access, stable provider networks that meet unit cost performance and trend-management objectives.
Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards, and other key process controls.
Ensure network composition includes an appropriate distribution of provider specialties.
Develop provider networks that produce affordable and predictable products for customers and business partners.
Establish and maintain strong business relationships with hospital, physician, pharmacy, and ancillary providers.
Provide explanations and information to others on difficult issues.
Coach, provide feedback, and guide others.
Support a government Service Contract Act agreement if employed in a job labeled “SCA.”