Remote Senior Director, Network Contracting

UnitedHealth Group; Columbus (OH); Remote; Confidential; Full time

Job summary

UnitedHealth Group's Associate Director, Network Contracting will guide the development and support of provider networks while managing unit cost through financial and network pricing modeling, analysis and reporting. The role aims to yield a geographically competitive, broad-access network that achieves cost objectives and delivers affordable products for customers and partners.

The position requires strong negotiation skills, experience with Medicare/Managed Care reimbursement, and the ability

Qualifications

• 5+ years of experience in a network management-related role handling complex network providers with accountability for business results.
• 2+ years of medical cost and affordability experience
• 2+ years of experience with provider contracting and/or provider network management
• Experience using financial models and analysis to negotiate rates with providers
• Proven solid knowledge of Medicare and Managed Care Reimbursement
• Driver's License and access to reliable transportation
• Ability to travel 25% to OH/IN
• Ability to work EST standard business hours

Responsibilities

• Balance financial and operational impact of contracts to providers, members, UHN, and different customer groups when developing and/or negotiating contract terms
• Develop functional, market level and/or site strategy, plans, production and/or organizational priorities
• Apply network configuration and incentive-based payment models as appropriate to improve quality and efficiency
• Demonstrate understanding of applicable products for different lines of business (Employer and Individual; Medicare and Retirement; Community and State)
• Evaluate current contract performance to identify potential remediation opportunities and/or cost savings
• Demonstrate understanding of and utilize applicable financial tools and reports (internal financial models; external reports) to evaluate performance of current contracts
• 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 (rates; market share; products; provider networks; market intelligence; GeoAccess)
• Represent department in external meetings to gather relevant information, recommend solutions, execute on deliverables as assigned and explain results/decision/activities
• Develop and/or implement contracting strategies to support new benefits designs and plans

Skills

Network management

Medical cost experience

Provider contracting

Financial modeling

Medicare knowledge

Job description

UnitedHealth Group's Associate Director, Network Contracting will guide the development and support of provider networks while managing unit cost through financial and network pricing modeling, analysis and reporting. The role aims to yield a geographically competitive, broad-access network that achieves cost objectives and delivers affordable products for customers and partners.

The position requires strong negotiation skills, experience with Medicare/Managed Care reimbursement, and the ability