Manager of Network Contracting - Remote

Optum; New York (NY); Remote; USD 92,000 - 164,000; Full time

Benefits offered by this job

Comprehensive benefits

Incentive and recognition programs

Equity stock purchase and 401k

Job summary

OptumHealth is seeking a senior leader for provider contracting, capable of directing a team and shaping network strategies across the U.S. You will negotiate with large outpatient groups and health systems, drive pricing models, and align with strategic goals for payor contracts.

The position offers remote work from anywhere in the United States, with responsibilities spanning contract development, stakeholder management, and performance coaching to ensure delivery against client and

Qualifications

• 8+ years of experience in a network management-related role handling complex network providers with accountability for business results.
• 8+ years of experience in the health care industry.
• 6+ years of experience with provider contracting including development of product pricing and utilizing financial modeling in making rate decisions.
• Proven experience in managing teams and leading personnel.
• Knowledge of Medicare and Medicaid regulations and related payment systems.
• Demonstrated ability to work under pressure and stay customer-focused.
• Strong proficiency with MS Excel and Microsoft Office.

Responsibilities

• Analyze and negotiate provider contracts to achieve organizational goals.
• Lead, develop, and mentor a team of contracting professionals.
• Establish and manage relationships with providers across legal, financial, and clinical matters.
• Input contract projections into tools and analyze financial impact of contracts.
• Promote cross-functional collaboration with Finance, Network Operations, and Legal teams.
• Drive continuous improvement in contracting processes and team performance.
• Serve as escalation point for complex negotiations and disputes.
• Recruit, onboard, and retain top contracting talent.

Skills

Provider contracting

Team leadership

Financial modeling

Healthcare industry

Regulatory knowledge

Contract negotiations

MS Excel

Job description

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together. 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 direct reports, contracts, cost trend, relationships and network growth/strategy for Optum's Behavioral Health National provider networks through provider negotiations with large outpatient groups, facilities and other health systems. This position is responsible for executing network strategies to meet client and sales goals; contracting competitive rates; evolving the payment methodology to align with the line of business; and managing high-volume provider relationships.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. 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 directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Primary 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
• Lead, develop, and mentor a team of provider contracting professionals, establishing clear performance expectations, fostering professional growth, and driving accountability to organizational goals.
• Oversee workload prioritization, resource allocation, and team performance to ensure timely execution of contracting initiatives, provider negotiations, and strategic network objectives.
• Conduct performance evaluations, provide ongoing coaching and feedback, and create development plans that enhance employee engagement, capability, and succession readiness.
• Partner with senior leadership to establish departmental goals, implement strategic initiatives, and drive continuous improvement across contracting processes and team operations.
• Serve as an escalation point for complex provider negotiations, contract disputes, operational challenges, and relationship management issues, ensuring effective resolution and alignment with company objectives.
• Recruit, onboard, and retain top talent while cultivating an inclusive, high-performing culture focused on collaboration, innovation, and results.
• Promote cross-functional collaboration among Contracting, Finance, Healthcare Economics, Network Operations, Provider Services, Legal, and Clinical teams to achieve organizational priorities and strengthen network performance.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Required Qualifications

• 8+ years of experience in a network management-related role handling complex network providers with accountability for business results
• 8+ years of experience in the health care industry
• 6+ years of experience with provider contracting including development of product pricing and utilizing financial modeling in making rate decisions
• Proven experience in managing teams and leading personnel
• Knowledge of Medicare and Medicaid regulations
• In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Inpatient Psychiatric Facility Prospective Payment System (IPF-PPS), bundled arrangements, and value-based programs
• Proven highly customer-focused, adaptable, and able to perform under pressure
• Proven capable of working independently with minimal supervision
• Demonstrate exceptional organizational skills and attention to detail
• Intermediate level of proficiency with MS Excel and other Microsoft Office applications

Preferred Qualifications

• Experience working for a Fortune 500 company
• Experience with behavioral health specialties and market analysis/trends
• All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Application Deadline

This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.