Senior Network Contract Manager

UnitedHealth Group•Brentwood, TN

3h•$91,700 - $163,700•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 The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. 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 TN, you will have the flexibility to work remotely as you take on some tough challenges.

Requirements

Demonstrate expertise in provider network functions, ability to work in a fast-paced environment
Ability to take initiative and use problem-solving skills for issue resolution
Work independently with little need for instruction, guidance or direction
Must be attentive to detail, work with flexibility, and have the capability of multi-tasking to meet deadlines and deliverables
Analytical and problem-solving skills, with a demonstrated ability to gather, understand, and evaluate information from various sources
Ability to prioritize and manage concurrent, and occasionally, competing initiatives
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.

Nice To Haves

Experience with performance-based contracts
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, trend management and appropriate distribution of provider specialties
Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls with a focus on hospitals, clinics, and ancillary providers
Forecast and plan resource requirements
Authorize deviations from standards