Network Contract Manager - Remote - Mid-Atlantic Region Preferred

UnitedHealthcare; Columbia (MD); Remote; USD 73,000 - 130,000; Full time

Job summary

UnitedHealthcare is seeking a Network Contract Manager to develop and negotiate physician contracts, build a broad access network, and manage unit cost performance to deliver affordable products for customers and business partners. The role involves interpreting customer needs, forecasting renewal strategy, and solving complex problems.

You will work with limited guidance, translate concepts into practice, and coach others while traveling up to 25% within the Mid-Atlantic region.

Qualifications

• 3+ years of experience in a network management-related role, such as contracting.
• 2+ years of experience in fee schedule development using actuarial models.
• 2+ years of experience using financial models in negotiating rates with providers.
• 2+ years of experience in performing network adequacy analysis.
• Intermediate knowledge of claims processing systems and guidelines.
• In-depth knowledge of Medicare reimbursement methodologies, i.e. RBRVS.
• Willing and able to travel up to 25% (w/in the mid-Atlantic territory).
• Driver's License and access to reliable transportation.

Responsibilities

• Assess and interpret customer needs and requirements
• Negotiate physician contracts
• Forecast and plan ongoing physician contract renewal strategy
• Identify solutions to non-standard requests and problems
• Solve moderately complex problems and / or conduct moderately complex analyses
• Work with minimal guidance; seek guidance on only the most complex tasks
• Translate concepts into practice
• Provide explanations and information to others on difficult issues
• Coach, provide feedback, and guide others
• Act as a resource for others with less experience

Skills

Network management

Fee schedule development

Financial modeling

Network adequacy analysis

Claims processing systems

Medicare reimbursement (RBRVS)

Willing to travel

Driver's license

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 to start Caring. Connecting. Growing together

The Network Contract Manager develops the provider network (physicians) yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management and produces an affordable and predictable product for customers and business partners. Network Contract Managers evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining solid business relationships with Physician or Ancillary providers and ensuring the network composition includes an appropriate distribution of provider specialties.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Mid-Atlantic Region preferred.

Primary Responsibilities

• Assess and interpret customer needs and requirements
• Negotiate physician contracts
• Forecast and plan ongoing physician contract renewal strategy
• Identify solutions to non-standard requests and problems
• Solve moderately complex problems and / or conduct moderately complex analyses
• Work with minimal guidance; seek guidance on only the most complex tasks
• Translate concepts into practice
• Provide explanations and information to others on difficult issues
• Coach, provide feedback, and guide others
• Act as a resource for others with less experience

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

• 3+ years of experience in a network management - related role, such as contracting
• 2+ years of experience in fee schedule development using actuarial models
• 2+ years of experience utilizing financial models and analysis in negotiating rates with providers
• 2+ years of experience in performing network adequacy analysis
• Intermediate level of knowledge of claims processing systems and guidelines
• In-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)
• Willing and able to travel up to 25% (w/in the mid-Atlantic territory)
• Driver's License and access to reliable transportation

Preferred Qualifications

• Proven excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information form others
• Demonstrated solid interpersonal skills, establishing rapport and working well with others
• Demonstrated solid customer service skills
• All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

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.

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 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.

UnitedHealth Group 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.

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