Network Contract Manager
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. Get ready for some significant challenge. 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. You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. Preference for those residing in California. Potential for 10%25 of travel.
Requirements
- 4+ years of experience in a network management-related role, such as contracting or provider services
- 3+ years of experience using financial models and analysis to negotiate rates with providers
- 3+ years of experience in performing network adequacy analysis
- 2+ years of experience in fee schedule development using actuarial models
- Intermediate level of knowledge of Medicare Resource Based Relative Value System (RBRVS)
- Intermediate level of knowledge of claims processing systems and guidelines
Nice To Haves
- Undergraduate degree
- Experience and knowledge with using tools and platforms such as Microsoft Copilot, Teams, OneNote, Salesforce etc
- Commercial and Medicare line of business experience
- Ability to manage competing priorities and remain organized
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
- Work with internal business partners on managing and addressing provider issues
Benefits
- a comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
