Network Contract Manager - Remote (Midwest preferred)

UnitedHealthcare; Minnetonka (MN); On-site; USD 73,000 - 130,000; Full time

Job summary

UnitedHealth Group is seeking a manager in our network contracting team to lead the development and support of Provider Networks, and to drive unit-cost management through financial and network pricing modeling, analysis, and reporting.

If you are located in the Midwest, you will have the flexibility to work remotely as you tackle challenging issues, with a focus on negotiating contracts and ensuring a geographically competitive network.

Qualifications

• 4+ years in a network management-related role (contracting, CME, or roster management).
• 3+ years developing fee schedules using actuarial models.
• 3+ years using financial models to negotiate provider rates.
• 3+ years performing network adequacy analysis.
• In-depth knowledge of Medicare RBRVS.
• Intermediate knowledge of claims processing systems and guidelines.
• Remote employees must 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 and trend management.
• Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls.
• Ensure that network composition includes an appropriate distribution of provider specialties.
• Provide explanations and information to others on difficult issues.
• Coach, provide feedback and guide others.

Skills

Network management experience

Contracting / CME / roster management

Fee schedule development

Financial modeling & rate negotiation

Network adequacy analysis

RBRVS knowledge

Claims processing systems knowledge

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

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 5 leader.

If you are located in Midwest, you will have the flexibility to work remotely* as you take on some tough challenges

Primary 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 and trend management
• Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls
• Ensure that network composition includes an appropriate distribution of provider specialties
• 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.

Develops the provider network (physicians, hospitals, pharmacies, ancillary groups & facilities, etc.) 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. Evaluates and negotiates contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Establishes and maintains strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensures the network composition includes an appropriate distribution of provider specialties. *Employees in jobs labeled with 'SCA' must support a government Service Contract Act (SCA) agreement.

• Generally work is self-directed and not prescribed
• Works with less structured, more complex issues
• Serves as a resource to 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.

Please review the Required Qualifications and you must meet or exceed the requirements listed below to be eligible to apply to this position.

Required Qualifications

• 4+ years of experience in a network management-related role, such as contracting, CME or roster management
• 3+ years of experience in fee schedule development using actuarial models
• 3+ years of experience using financial models and analysis to negotiate rates with providers
• 3+ years of experience in performing network adequacy analysis
• In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
• 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

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 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.