Regional Contract Manager - Remote

UnitedHealth Group; La Crosse (WI); Hybrid; USD 73,000 - 130,000; Full time

Benefits offered by this job

Comprehensive benefits package

401(k) plan

Employee recognition programs

Job summary

UnitedHealth Group in La Crosse, WI seeks a Network Contract Manager to build and optimize a broad provider network including physicians, hospitals, and ancillary groups. You will negotiate terms, balance financial and operational impact, and maintain key relationships to deliver affordable, accessible care.

The role requires strong contract acumen, market awareness, and collaboration with internal partners to implement strategy and drive network performance.

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.

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 escape 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

Skills

Contract terminology

Financial analysis

Contract management systems

Market/competitor awareness

Provider contract negotiations

Tools

Contract management systems

Job description

Explore opportunities with Logistics Health Incorporated (LHI), part of the Optum family of business. We're dedicated to simplifying the logistics of complex workforce health programs with cost-effective solutions and a seamless distribution process. With offices in La Crosse, Wis., a satellite office in Chicago and remote employees throughout the country, we have a variety of rewarding career opportunities for you. Elevate your career as you help us create a healthier tomorrow for everyone and discover the meaning behind 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

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 escape 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’llbe 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 asprovidedevelopment 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 Qualifications:

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

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.