Network Contract Manager

UnitedHealth Group; Orlando (FL); On-site; USD 73,000 - 130,000; Full time

Benefits offered by this job

Comprehensive benefits

Incentive programs

Equity stock purchase

401k contribution

Job summary

UnitedHealthcare, a unit of UnitedHealth Group, is seeking a Manager in Network Contracting to lead contract development and cost management for government-focused and South Atlantic provider groups. You will negotiate agreements, guide network design, and ensure cost optimization while collaborating across lines of business.

The role emphasizes strategic thinking, cross-functional influence, and delivering results in a fast-paced environment with data challenges.

Qualifications

• 2+ years of experience in the health care industry.
• 2+ years of experience in a network management-related role (contracting, provider services, or provider data operations).
• In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS).
• Ability to prioritize tasks and work effectively under time constraints.
• Excellent verbal and written communication skills.
• Excels in building key internal & external business relationships to meet the needs of our customers and partners.

Responsibilities

• Evaluate and negotiate contracts with a concentration in FQHC/RHCs in the South Atlantic market and Government Focus provider groups.
• Manage unit cost budgets, target setting, performance reporting and associated financial models.
• Guide development of geographically competitive networks that achieve unit cost performance objectives.
• Ensure network composition includes an appropriate distribution of provider specialties.
• Support Government Risk Contracting goals and objectives for all Government LOBs.
• Provide day-to-day management of Risk contracting activities and contract execution/maintenance.
• Collaborate across lines of business and with LOB leaders, HCE, and Capitation Operations.
• Provide explanations and information on difficult issues.
• Coach, provide feedback and guide others.
• Prepare for a fast-paced environment with data challenges and process gaps.

Skills

Healthcare experience

Network management

RBRVS knowledge

Communication skills

Relationship building

Job description

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 in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

It's a big step forward when you realize that you've earned the trust to lead a team. Now, let's determine just how big that step can be. Take on this managerial role with UnitedHealth Group and you'll be part of a team that's reshaping how provider networks evolve and how health care works better for millions. As a manager within our network contracting team, 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 6 leader.

Primary Responsibilities:

• Evaluate and negotiate contracts in compliance with company template, reimbursement structure standards and other key process controls with a concentration in FQHC/RHC's in the South Atlantic market and Government Focus provider groups
• 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
• Ensure that network composition includes an appropriate distribution of provider specialties
• Support Government Risk Contracting Manager/Director to achieve Risk contracting goals and objectives for all Government LOB's
• Provide day-to-day management of Risk contracting activities, including project management, problem resolution and other activities to drive Capitation contract execution/maintenance
• Work effectively across lines of business and across the organization including interactions with LOB leaders, HCE, and Capitation Operations
• Provide explanations and information to others on difficult issues
• Coach, provide feedback and guide others
• 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 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.

Required Qualifications:

• 2+ years of experience in the health care industry
• 2+ years of experience in a network management-related role, such as contracting, provider services, or provider data operations
• In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
• Ability to prioritize tasks and work effectively under time constraints
• Excellent verbal and written communication skills
• Excels in building key internal & external business relationships to meet the needs of our customers and partners

Preferred Qualifications:

• 3+ years of experience with large provider contracting including development of product pricing and utilizing financial modeling in making rate decisions
• 2+ years of experience in fee schedule development using actuarial model
• 2+ years of experience using financial models and analysis to negotiate rates with providers
• 2+ years of experience in performing network adequacy analysis
• Experience in health plans with a demonstrated focus on Capitation/value-based contracting

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 $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.