Network Contract Manager - Remote in WI, IL or St. Louis, MO

UnitedHealth Group; La Crosse (WI); Remote; Confidential; Full time

Job summary

An established industry player is seeking a Network Contract Manager to join their dynamic team. This role involves building a competitive provider network and ensuring its stability while achieving cost performance goals. The ideal candidate will have a strong background in network contracting and provider relations, with the ability to negotiate contracts effectively. You will enjoy the flexibility of remote work while tackling challenging responsibilities that directly impact the health care landscape. Join a mission-driven organization where your contributions will help improve health outcomes for diverse communities.

Benefits

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Qualifications

• 2+ years of experience in network contracting or provider relations.
• Understanding of financial tools for rate development.
• Ability to assess contract language and implications.

Responsibilities

• Conduct outreach to potential providers for network building.
• Negotiate contracts while ensuring compliance with standards.
• Monitor provider performance and market trends for improvements.

Skills

Network Contracting

Provider Relations

Contract Negotiation

Financial Analysis

Sales Negotiation

Education

Bachelor's Degree

Tools

Contract Management Systems

Job description

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

The Network Contract Manager will assist in building a provider network, including physicians, hospitals, pharmacies, ancillary groups, and facilities. This network will be geographically competitive, offer broad access, and remain stable, meeting goals for cost performance and trend management. The resulting network will deliver an affordable and predictable product for customers and business partners

If you are located in WI, IL or St. Louis, MO, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Conducts outreach to potential providers
• Supports development of the provider network (physicians, pharmacies, ancillary groups & facilities, etc.) yielding a geographically competitive, broad access, stable network that achieves objectives for cost performance
• Performs straightforward contract negotiation and pricing - evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls
• Establishes and maintains solid business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties
• Balance financial and operational impact of contracts to providers, members, and different customer groups when developing and/or negotiating contract terms
• Support evaluation of 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 internal partners and providers in order to justify methodologies, processes, policies, and procedures
• Identify and gather information regarding provider issues in order to develop and/or implement strategy to resolve matter, keep manager informed of progress, or escalate issue to appropriate internal business partner
• Represent department in external meetings (e.g., ancillary providers; physician groups; facilities) to gather relevant information, recommend solutions, execute on deliverables as assigned and explain results/decision/activities
• Monitor and/or oversee provider financial performance to identify opportunities to improve performance and/or provider relationship
• Monitor and/or oversee network performance and industry trends to identify opportunities to refine, develop, and/or implement market strategies
• Other duties as assigned

Key Work Attributes

• Generally work is self-directed and not prescribed. Serves as a resource to others
• Works with less structured, more complex issues
• Ability to adapt quickly as an high growth less mature business contributes to a dynamic, fluid, high learning work environment
• Assesses and interprets customer needs and requirements
• Identifies solutions to non-standard requests and problems
• Solves moderately complex problems and/or conducts moderately complex analyses
• Works with minimal guidance; seeks guidance on only the most complex tasks
• Coaches, provides feedback, and guides others. Acts as a resource for others

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 with network contracting or provider relations in a managed care environment
• Demonstrate understanding of and utilize applicable financial tools and reports to develop rates
• Demonstrate understanding of contract language in order to assess financial and operational impact and legal implications of requested contract changes
• Demonstrate understanding of competitor landscape within the market
• Proven ability to utilize appropriate contract management systems to author and execute contracts and to access supplemental contractual documents

Preferred Qualification:

• Sales experience to effectively negotiate contracts and establish solid business relationships with providers

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

The salary range for this role is $71,600 to $140,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

OptumCare is 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.