Senior Network Contract Manager - Remote

UnitedHealth Group•Charleston, SC

6d•$91,700 - $163,700•Remote

About The Position

This self-directed role with OptumHealth will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. You will manage contracts, cost trend, relationships and network growth/strategy for Optum’s Centers of Excellence provider networks (transplant, cancer, congenital heart disease and VAD) through provider negotiations with large academic hospitals and health systems. This position is responsible for executing on network strategies to meet client and sales goals; contracting competitive rates; evolving the payment methodology to align with the line of business; and managing provider relationships. If you are located in South Carolina area, you will have the flexibility to work remotely as you take on some tough challenges. In this role, you will need to be able to thrive in a demanding, intense, fast-paced environment. In addition, you’ll be driving some complex negotiations while striving to ensure accuracy. 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

5+ years of experience in a network management-related role handling complex network providers with accountability for business results
5+ years of experience in the health care industry
2+ years of experience with provider contracting including development of product pricing and utilizing financial modeling in making rate decisions
In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.
Knowledge of Medicare and Medicaid regulations
Intermediate level of proficiency with MS Excel and other Microsoft Office applications
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
Candidates are required to pass a drug test before beginning employment.

Nice To Haves

Experience with in vivo gene therapy COE networks

Responsibilities

Analyze and evaluate payment appendices to strategize options for various contracting approaches and methodologies
Evaluate market rates and provider performance (e.g., billing patterns; referral patterns; quality and effectiveness) in order to establish provider rates and negotiation strategies
Explain the organization's direction and strategy to providers in order to justify methodologies, processes, policies, and procedures
Input contract projections accurately into appropriate tools and analyze financial impact of provider contracts to achieve company goals
Communicate proposed contractual terms with provider and negotiate mutually acceptable agreement
Establish and manage relationships with providers to navigate operational, legal, financial and clinical matters