Senior Network Contract Manager - Remote
About The Position
OptumHealth is hiring a self-directed Senior Network Contract Manager to manage contracts, cost trends, provider relationships, and network growth and strategy for Optum Centers of Excellence provider networks, including transplant, cancer, congenital heart disease, and VAD. The role negotiates with large academic hospitals and health systems and executes network strategies that support client and sales goals, competitive rates, payment methodologies aligned with the line of business, and effective provider relationships. The position is remote within the United States. It requires working effectively in a demanding, intense, fast-paced environment, leading complex negotiations, and maintaining accuracy. Remote employees must adhere to UnitedHealth Group’s Telecommuter Policy. Candidates must pass a drug test before beginning employment.
Requirements
- At least 5 years of experience in a network management-related role handling complex network providers with accountability for business results.
- At least 5 years of experience in the health care industry.
- At least 2 years of experience with provider contracting, including developing product pricing and using financial modeling to make rate decisions.
- Knowledge of Medicare and Medicaid regulations.
- In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, or similar systems.
- Intermediate proficiency with MS Excel and other Microsoft Office applications.
- Valid driver’s license and access to reliable transportation.
- Ability to thrive in a demanding, intense, fast-paced environment, drive complex negotiations, and maintain accuracy.
- Ability to pass a drug test before beginning employment.
Nice To Haves
- Experience working for a Fortune 500 company.
- Experience with high-cost cell and gene therapies, organ transplants, or cancer specialties.
Responsibilities
- Analyze and evaluate payment appendices to develop options for contracting approaches and methodologies.
- Evaluate market rates and provider performance, including billing patterns, referral patterns, quality, and effectiveness, to establish provider rates and negotiation strategies.
- Explain the organization’s direction and strategy to providers to support methodologies, processes, policies, and procedures.
- Accurately enter contract projections into appropriate tools and analyze the financial impact of provider contracts to achieve company goals.
- Communicate proposed contractual terms to providers and negotiate mutually acceptable agreements.
- Establish and manage provider relationships to address operational, legal, financial, and clinical matters.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs.
- Equity stock purchase plan.
- 401(k) contribution, subject to eligibility requirements.
- Career development opportunities.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
