Network Contract Manager - Remote (Texas resident preferred)

UnitedHealth Group; Houston (TX); Remote; USD 73,000 - 130,000; Full time

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase

401k contribution

Job summary

UnitedHealth Group's UnitedHealthcare division seeks a Network Contract Manager to help build a geographically competitive, broad-access network and to negotiate contracts that balance cost with value. You will partner with physicians, hospitals and other providers to ensure coverage aligns with company guidelines and patient needs.

This role offers remote work from anywhere in the U.S., a comprehensive benefits package, and opportunities to influence reimbursement strategies and network

Qualifications

• 3+ years of experience in a network management-related role, such as contracting or provider services.
• 3+ years of experience in fee schedule development using actuarial models.
• 3+ years of experience in performing network adequacy analysis.
• 2+ years of experience using financial models and analysis to negotiate rates with providers.
• In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS).
• Intermediate level of knowledge of claims processing systems and guidelines.

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

Contracting

Provider services

Actuarial models

Network adequacy

Financial modeling

RBRVS knowledge

Claims processing knowledge

Education

Undergraduate degree

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 equitable. Ready to make a difference? Join us and start doingyour life's best work. (sm)

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 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.

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

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.

Required Qualifications:

• 3+ years of experience in a network management-related role, such as contracting or provider services
• 3+ years of experience in fee schedule development using actuarial models
• 3+ years of experience in performing network adequacy analysis
• 2+ years of experience using financial models and analysis to negotiate rates with providers
• In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS)
• Intermediate level of knowledge of claims processing systems and guidelines

Preferred Qualifications:

• Undergraduate degree

*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 to $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 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.